The missed early diagnosis of ‘Siamese twins’ - ethical dilemma and role of family physicians

• Main Authors: Jamani, Nurjasmine Aida, Sururi, Nur Fitrahana
• Format: Proceeding Paper
• Language: English; English
• Published: 2023
• Subjects: R Medicine (General); RA Public aspects of medicine; RG Gynecology and obstetrics; RZ Other systems of medicine
• Online Access: http://irep.iium.edu.my/106576/13/106576_The%20missed%20early%20diagnosis%20of%20%E2%80%98Siamese%20Twins%E2%80%99-Ethical.pdf; http://irep.iium.edu.my/106576/14/106576_The%20missed%20early%20diagnosis%20of%20%E2%80%98Siamese%20Twins%E2%80%99-Ethical_supplemental.pdf; http://irep.iium.edu.my/106576/; https://fmsconference.my/

A 25-year-old primigravida presents for Post Covid Assessment at 18 weeks gestation. During the assessment, ultrasound showed two fetuses with 2 arms, 2 legs, and 2 heads. The twins were joined at the thorax and upper abdomen. There was a single umbilical cord, and only one fetal heart was observed. A thoracophagus conjoined twin was diagnosed and referred to a Materno-Fetal Medicine Specialist. She had her early trimester scan done previously in a health clinic which showed a singleton fetus at 9 weeks of gestation. Diagnosis and prognosis were explained to both parents. Initially they were reluctant for termination of pregnancy due to cultural and religious beliefs. Subsequently, the parents agree to terminate the pregnancy. A stillborn female thoracophagus conjoined twins were delivered through spontaneous vaginal delivery weighing 750g at 21 weeks period of gestation. Lactation was suppressed and psychological support was given throughout the postnatal care.