Conjoined twins battling for survival at NICH


KARACHI – Two-day old conjoined twins, who were born in a private maternity home in Quaidabad, were shifted to the National Institute of Child Health (NICH) on Tuesday. Their parents are residents of Feature Colony, Quaidabad.
The twins are joined at their chest and have single heart and liver as well as one set of external female genitalia.
They have two lower limbs, three upper limbs, one pair of lungs and one common intestine with one stomach. The on-duty doctors said that the twins are in a critical condition. They are suffering from an infection and their bodies are unable to bear the excessive load as they share their vital organs.
After receiving the twins, the NICH administration shifted them to the surgical ICU and Prof Jamshed Akhtar was assigned to look after them.
Prof Raza, a pediatric endocrinologist, told Pakistan Today that the incidence of live conjoined twins (technically known as parapagus) is one set per 200,000 live births.
“The birth of conjoined twins is a random event, unrelated to heredity, maternal age or parity,” he said.
Two theories have been proposed to explain conjoined twinning. The classical theory or fission theory asserts that incomplete fission of a single embryonic disc occurs 13 to 15 days after the ovum is fertilised. More recently, embryologic studies of conjoined twinning have indicated an alternative postulation that this developmental anomaly could originate from the secondary fusion of two separate monovular embryonic discs. This is called the fusion theory.
Conjoined twins are mainly classified according to incomplete duplication (parasitic) or complete duplication and there are eight types of completely duplicated conjoined twins according to the most prominent site of union.
“The most common type of union is thoracopagus and or omphalo-pagus (anterior thoracoabdominal fusion) and is found in 40 to 75 percent cases,” Prof Raza said.


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