31:
266:
and other organs in the pelvic region, it takes months of planning to decide whether or not separation of the twins outweighs the complications and risks associated with surgery and reconstruction of organs. Surgery to separate conjoined twins has allowed surgeons to be able to study the mechanisms
252:
For the
Ischiopagus twins that both survive from birth, complications and risks also arise. Usually if both twins survive labor, one twin will be healthy and strong, while the other is malnourished and weak. Thus, surgery would have to be planned in advance to understand the best option and how to
299:
occurring in about 1 in every 100,000 live births and occurring in 1 out of 10 conjoined twin births. Most
Ischiopagus cases are common in the areas of India and Africa. Of the varieties of Ischiopagus twins, Ischiopagus Tetrapus is more prevalent, happening in 68.75% of all Ischiopagus cases.
261:
Separation is the only treatment for
Ischiopagus. The rarity of the condition as well as the challenge it presents in separating the twins has been difficult to understand. In recent years, with advancing medical technology, physicians have been able to successfully separate Ischiopagus twins.
240:
are born. The parasitic twin has no hope for survival and dies and is then surgically separated from its twin. Depending upon how the twins are attached and what is shared among them, complications can arise from surgically separating the live twin from the dead twin. In
Ischiopagus cases, the
286:
Depending upon what organs are shared among the twins and if they are surgically separable, usually only one of the twins makes it through the surgery or they both die due to complications either before or during the surgery. Now that successful surgery has been reported and more findings are
287:
becoming available due to research and pre-surgery evaluation, better surgery techniques and procedures will be available in the future to help increase the survival rate of ischiopagus twins as well as other conjoined twins.
164:
which can lead to a conjoining of the twins as a result of the twins not separating properly during the twinning process. Separation occurring between the seventh and thirteenth days should result in a
83:. Parapagus is also similar to ischiopagus; however, parapagus twins are joined side-by-side whereas ischiopagus twins typically have spines connected at a 180° angle, facing away from one another.
160:
for conjoined twins such as ischiopagi, the twins form by the splitting of a bi-laminar embryonic disc after the formation of the inner cell masses. Thus, making the twins occupy the same
262:
However, it depends on the organs shared, how closely joined the twins are, and what risks could rise from separating the twins during surgery. Since
Ischiopagus twins usually share a
249:
region. Ischiopagus twins need reconstructive surgery for the genitals and gastrointestinal tract in order for normal bowel movements and reproductive possibilities in adulthood.
362:
577:
75:
where the twins are joined dorsally at the buttocks facing away from each other, whereas ischiopagus twins are joined ventrally and caudally at the
101:
These twins share three legs, the third leg is often two fused legs, or is non-functioning. The twins also usually share only one set of external
716:
189:
or double overlapping inducing centers on the same germ disc. Various studies suggest that mechanical disturbances such as shaking of the
224:. However, studies have shown that these disturbances must happen at critical times in the pregnancy for the conjoined twins to develop.
115:. The axes extends in a straight line but in opposite directions. The lower extremities are oriented at right angles to the axes of the
621:
502:
388:
185:
will develop. The origin of exactly what goes wrong to produce ischiopagus or any conjoined twin is a result by either incomplete
626:
336:
68:
at 180°. The conjoined twins usually have four arms; two, three or four legs; and typically one external genitalia and anus.
570:
319:
300:
Ischiopagus Tripus occurs in 31.25% of cases while
Ischiopagus Dipus occurs in only 6.25% of all Ischiopagus cases.
711:
563:
111:
This variety has the twins at a symmetrical continuous longitudinal axis with their area of union not broken
654:
263:
242:
374:
372:
201:
30:
177:. If separation of the twins occur in the later stages of development prior to the appearance of the
157:
613:
156:. Although the latter is more frequent, monozygotic is the reason conjoined twins can develop. In
685:
631:
296:
95:
This is the rarest variety with the twins sharing two legs with no lower extremities on one side.
541:
498:
475:
440:
384:
356:
221:
194:
186:
531:
467:
430:
422:
178:
641:
323:
278:
Separating ischiopagus tripus conjoined twins usually leaves the twins with one leg each.
182:
153:
145:
137:
57:
680:
649:
536:
519:
435:
410:
237:
65:
705:
659:
426:
404:
402:
400:
268:
166:
458:
Spencer, Rowena (3 January 1992). "Conjoined Twins: Theoretical
Embryologic Basis".
193:, exposure of the embryo to cold or insufficient oxygen during the early process of
132:
During embryonic development, twins can form from the splitting of a single embryo (
170:
340:
690:
190:
133:
272:
112:
471:
233:
149:
102:
72:
545:
316:
17:
479:
444:
595:
217:
213:
209:
205:
198:
174:
246:
141:
120:
53:
381:
Conjoined Twins: Developmental
Malformations and Clinical Implications
161:
116:
80:
76:
61:
555:
236:
or dying shortly after birth. In some cases, a healthy twin and a
29:
603:
586:
559:
411:"Successful Separation of Ischiopagus Tetrapus Conjoined Twins"
253:
keep both children alive during surgery as well as afterwards.
37:
conjoined twins who died in a hospital pre-surgery in 2011
64:. The twins are classically joined with the vertebral
181:
and axial orientation, then it can be predicted that
497:. Elsevier Churchill Livingstone. pp. 179–182.
673:
640:
612:
594:
317:Duplicata incompleta, dicephalus dipus dibrachius
241:children share a pelvic region along with the
571:
409:Eades, Joseph; Colin Thomas (17 March 1966).
271:as well as the physiological consequences of
119:and the adjacent limbs near the union of the
8:
578:
564:
556:
232:Conjoined twins are at high risk to being
535:
434:
309:
220:can cause the incomplete separation of
361:: CS1 maint: archived copy as title (
354:
140:or the twins can arise from separate
7:
520:"Ischiopagus Tripus Conjoined Twins"
52:meaning fixed or united. It is the
27:Conjoined twins fused at the pelvis
25:
622:Twin-to-twin transfusion syndrome
627:Twin reversed arterial perfusion
427:10.1097/00000658-196612000-00017
60:(Class V) who are united at the
383:. JHU Press. pp. 184–193.
518:Khan, Yousuf (10 March 2011).
212:together, or constricting the
108:Ischiopagus tetrapus/quadripus
1:
717:Animal developmental biology
524:APSP Journal of Case Reports
123:belong to the opposite twin.
71:It is mostly confused with
733:
173:identical twins sharing a
44:comes from the Greek word
495:Larsen's Human Embryology
493:Schoenwolf, Gary (2009).
379:Spencer, Rowena (2003).
48:meaning hip (ilium) and
655:Craniopagus parasiticus
472:10.1002/tera.1420450604
295:Ischiopagus is a rare
264:gastrointestinal tract
243:gastrointestinal tract
38:
33:
343:on February 23, 2014
158:monozygotic twinning
614:Monochorionic twins
632:Monoamniotic twins
322:2009-08-19 at the
98:Ischiopagus tripus
39:
35:Ischiopagus Tripus
699:
698:
415:Annals of Surgery
222:monozygotic twins
92:Ischiopagus dipus
16:(Redirected from
724:
580:
573:
566:
557:
550:
549:
539:
515:
509:
508:
490:
484:
483:
455:
449:
448:
438:
421:(6): 1059–1072.
406:
395:
394:
376:
367:
366:
360:
352:
350:
348:
339:. Archived from
333:
327:
314:
179:primitive streak
21:
732:
731:
727:
726:
725:
723:
722:
721:
712:Conjoined twins
702:
701:
700:
695:
669:
642:Conjoined twins
636:
608:
590:
584:
554:
553:
517:
516:
512:
505:
492:
491:
487:
457:
456:
452:
408:
407:
398:
391:
378:
377:
370:
353:
346:
344:
337:"Archived copy"
335:
334:
330:
324:Wayback Machine
315:
311:
306:
293:
284:
259:
230:
183:conjoined twins
154:fraternal twins
146:menstrual cycle
138:identical twins
130:
89:
58:conjoined twins
28:
23:
22:
15:
12:
11:
5:
730:
728:
720:
719:
714:
704:
703:
697:
696:
694:
693:
688:
683:
681:Vanishing twin
677:
675:
671:
670:
668:
667:
666:
665:
657:
650:Parasitic twin
646:
644:
638:
637:
635:
634:
629:
624:
618:
616:
610:
609:
607:
606:
600:
598:
592:
591:
585:
583:
582:
575:
568:
560:
552:
551:
510:
503:
485:
466:(6): 591–602.
450:
396:
389:
368:
328:
308:
307:
305:
302:
292:
289:
283:
280:
258:
255:
238:parasitic twin
229:
226:
152:) which forms
136:) which forms
129:
126:
125:
124:
109:
106:
99:
96:
93:
88:
87:Classification
85:
56:term used for
26:
24:
14:
13:
10:
9:
6:
4:
3:
2:
729:
718:
715:
713:
710:
709:
707:
692:
689:
687:
684:
682:
679:
678:
676:
672:
664:
663:
658:
656:
653:
652:
651:
648:
647:
645:
643:
639:
633:
630:
628:
625:
623:
620:
619:
617:
615:
611:
605:
602:
601:
599:
597:
593:
588:
581:
576:
574:
569:
567:
562:
561:
558:
547:
543:
538:
533:
529:
525:
521:
514:
511:
506:
504:9780443068119
500:
496:
489:
486:
481:
477:
473:
469:
465:
461:
454:
451:
446:
442:
437:
432:
428:
424:
420:
416:
412:
405:
403:
401:
397:
392:
390:9780801870705
386:
382:
375:
373:
369:
364:
358:
342:
338:
332:
329:
325:
321:
318:
313:
310:
303:
301:
298:
290:
288:
281:
279:
276:
274:
270:
269:embryogenesis
265:
256:
254:
250:
248:
244:
239:
235:
228:Complications
227:
225:
223:
219:
215:
211:
207:
203:
200:
196:
192:
188:
184:
180:
176:
172:
168:
167:monochorionic
163:
159:
155:
151:
147:
143:
139:
135:
127:
122:
118:
114:
110:
107:
104:
100:
97:
94:
91:
90:
86:
84:
82:
78:
74:
69:
67:
63:
59:
55:
51:
47:
43:
36:
32:
19:
661:
527:
523:
513:
494:
488:
463:
459:
453:
418:
414:
380:
347:February 10,
345:. Retrieved
341:the original
331:
326:, 2008-06-20
312:
294:
291:Epidemiology
285:
277:
260:
251:
231:
171:monoamniotic
144:in the same
131:
70:
49:
45:
41:
40:
34:
691:Mixed twins
191:blastomeres
134:monozygotic
18:Ischiopagus
706:Categories
589:conditions
460:Teratology
304:References
273:parabiosis
208:or half a
128:Embryology
113:anteriorly
42:Ischiopagi
686:Chimerism
282:Prognosis
257:Treatment
234:stillborn
216:or early
202:organizer
150:dizygotic
103:genitalia
73:pygopagus
596:Zygosity
546:22953272
530:(1): 5.
357:cite web
320:Archived
218:gastrula
214:blastula
210:gastrula
206:gastrula
199:grafting
195:cleavage
175:yolk sac
662:in fetu
537:3418005
480:1412053
445:5926243
436:1477223
297:anomaly
247:genital
187:fission
142:oocytes
121:ischium
54:medical
46:ischio-
660:Fetus
544:
534:
501:
478:
443:
433:
387:
162:amnion
117:thorax
81:coccyx
77:sacrum
62:pelvis
50:-pagus
674:Other
204:onto
604:Twin
587:Twin
542:PMID
499:ISBN
476:PMID
441:PMID
385:ISBN
363:link
349:2014
245:and
79:and
66:axis
532:PMC
468:doi
431:PMC
423:doi
419:164
267:of
708::
540:.
526:.
522:.
474:.
464:45
462:.
439:.
429:.
417:.
413:.
399:^
371:^
359:}}
355:{{
275:.
197:,
169:,
579:e
572:t
565:v
548:.
528:2
507:.
482:.
470::
447:.
425::
393:.
365:)
351:.
148:(
105:.
20:)
Text is available under the Creative Commons Attribution-ShareAlike License. Additional terms may apply.
