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Diamniotic Conjoined Fetuses in a Triplet Pregnancy: An Insight Into Embryonic Topology

  • Case Report
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Pediatric and Developmental Pathology

ABSTRACT

We present a case of triplets, 2 of whom were monochorionic diamniotic conjoined fetuses, and the other triplet was in a separate chorion. The pregnancy followed in vitro fertilization with 2 embryo transfers and the conjoined fetuses developed from a single embryo. An early ultrasound showed 2 embryos attached to 1 yolk sac. Further monitoring of the pregnancy showed these 2 triplets to be diamniotic with a short umbilical cord/body stalk anomaly. After fetal loss a postmortem examination demonstrated that these fetuses were conjoined with a body stalk anomaly/short umbilical cord syndrome with fusion of the coelomic cavities and small bowel (minimally united/conjoined twins). There were dividing amniotic membranes. This case demonstrates the development of an unusual type of conjoined twin with characteristic features. Conjoined fetuses with this pattern have fused small bowel and cloacal anomalies and often diamniotic placentation, when this is recorded. Various terms including minimally united/conjoined omphalopagus/ischiopagus have been used for this characteristic pattern, but this pattern may warrant a specific term. “Diamniotic vitellopagus” may best reflect the pathogenesis of this pattern.

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Acknowledgments

The authors gratefully acknowledge the reviewers for their comments and the generous assistance of Dr. Bruce Beckwith in providing a translation of the relevant pages of the Taruffi reference and the relevant extract of the Collins reference and discussing and helping refine the ideas in this report.

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Authors and Affiliations

  1. Department of Pathology, King Edward Memorial Hospital, Bagot Road, Subiaco, WA, 6008, Australia

    Adrian Charles

  2. Department of Maternal-Fetal Medicine, King Edward Memorial Hospital, Bagot Road, Subiaco, WA, 6008, Australia

    Jan E. Dickinson

  3. The School of Women’s and Infants’ Health, The University of Western Australia, King Edward Memorial Hospital, Bagot Road, Perth, WA, 6008, Australia

    Adrian Charles & Jan E. Dickinson

  4. PIVET Medical Centre, 166 Cambridge Street, Wembley, WA, 6014, Australia

    Susan Watson, Nevile Phillips & John Yovich

Authors
  1. Adrian Charles
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  2. Jan E. Dickinson
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  3. Susan Watson
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  4. Nevile Phillips
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  5. John Yovich
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Corresponding author

Correspondence to Adrian Charles.

Additional information

This case was presented at the Paediatric Pathology Society Meeting; Cape Town, South Africa; April 2004

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Charles, A., Dickinson, J.E., Watson, S. et al. Diamniotic Conjoined Fetuses in a Triplet Pregnancy: An Insight Into Embryonic Topology. Pediatr Dev Pathol 8, 666–672 (2005). https://doi.org/10.1007/s10024-005-0009-8

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  • DOI: https://doi.org/10.1007/s10024-005-0009-8

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