Conjoined Twins

Diagnosis

Conjoined twins can be diagnosed during a routine ultrasound as early as 7 to 12 weeks of pregnancy. More-detailed ultrasounds and echocardiograms (sound wave tests of the babies’ hearts) are performed around the midpoint of pregnancy to assess how the twins are connected and how their organs function.

If conjoined twins are detected, a magnetic resonance imaging (MRI) scan may be done to provide detailed information about the connection points and shared organs.
Fetal MRI and fetal echocardiography help in planning prenatal and postnatal care.
After birth, additional tests are performed to determine organ function, body structure, and shared systems.

More Information:

• Echocardiogram

• MRI

• Ultrasound

Treatment

Treatment for conjoined twins depends on factors such as their connection site, shared organs, overall health, and potential complications.

Monitoring During Pregnancy

Mothers carrying conjoined twins require close monitoring throughout pregnancy. A maternal and fetal medicine specialist (high-risk pregnancy expert) manages the case, often with a multidisciplinary team including:

• Pediatric surgeon

• Pediatric urologist (urinary system)

• Pediatric orthopedic surgeon (bones and joints)

• Plastic and reconstructive surgeon

• Pediatric cardiologist (heart and blood vessels)

• Pediatric cardiovascular surgeon

• Neonatologist (newborn care)

The team studies the twins’ anatomy, functional capabilities, and prognosis to prepare a treatment plan.

Delivery

A C-section is usually scheduled 3 to 4 weeks before the due date.

After birth, the twins are thoroughly evaluated to decide if separation surgery is appropriate.

Separation Surgery

If separation is planned, it usually occurs between 6 to 12 months after birth, allowing time for detailed planning and preparation.

Emergency separation may be required if:

• One twin dies

• A twin develops a life-threatening condition

• The condition endangers both twins

Key considerations before surgery:

• Whether vital organs (such as the heart) are shared

• Whether both twins are strong enough for surgery

• The likelihood of success

• The extent of reconstructive surgery required

• The type of support needed after separation

• The quality of life if the twins remain joined

Recent advancements in imaging, anesthesia, and critical care have improved surgical outcomes.

After surgery, twins often need rehabilitation services, including:

• Physical therapy

• Occupational therapy

• Speech therapy

If Surgery Isn’t an Option

If separation isn’t possible or is declined, care focuses on supporting the twins’ health and comfort.

In severe cases, medical comfort care — including nutrition, fluids, pain relief, and human touch — is provided.

More Information:

• C-section

Coping and Support

Learning that your twins are conjoined can be emotionally overwhelming. Parents may face difficult choices and uncertain outcomes.

Support options include:

• Counseling with medical social workers or psychologists

• Parent support groups for families of children with complex physical conditions

• Online communities for emotional support

• Grief support if loss occurs

Preparing for Your Appointment

Before your appointment:

• Bring a family member or friend for emotional and informational support.

• Prepare a list of questions ranked by importance.

Suggested questions to ask:

• What tests do my twins need?

• Where are my twins joined and what organs are shared?

• What treatment plan do you recommend?

• Is separation possible, and what is the likely outcome?

• How experienced is your team with separation surgeries?

• What other specialists should be involved?

• Where can I find family support or educational resources?

• What are the chances of this recurring in future pregnancies?

What to Expect from Your Doctor

Your healthcare team will review test results, examinations, and imaging studies to explain all available treatment options.
Together, you’ll make decisions about the best possible care and future planning for your conjoined twins.