Triplet: Thoraco-omphalophagus Conjoint Twins and Malformed Fetus of Sokoto, North-Western Nigeria

Abstract

Conjoined twinning is one of the most fascinating human malformations. The incidence of conjoined is 1:50,000 to 1:100,000 live births, with 40–60% being stillborn and about 35% of the live births not surviving beyond 24 hours. The exact incidence of conjoint twins in Nigeria is not known as there are instances of under-reporting, largely due to the relatively poor prognosis and stigmatisation associated with conjoined twinning. We are reporting a case of thoraco-omphalophagus conjoint twins and a malformed third fetus diagnosed by ultrasound in the first trimester of pregnancy. A set of female conjoined twins and a malformed triplet, delivered by 25-year old primigravida via emergency Caesarean Section on the 22nd May 2021 on account of PROM and fetal distress at 34/52 GA, that were  admitted in our level one neonatal unit. The twins were joined at the thoraco-abdominal region. Echocardiography showed a moderate- sized Atrial Septal Defect in twin 1 and a large Ventricular Septal Defect in twin 2. MRI showed a thoraco-omphalophagus set of conjoined twins with fused xiphisternum, myocardium, pericardium, liver and small bowel.