# Two Souls, One Birth: The Vaginal Delivery of Parapagus Conjoined Twins

## TL;DR

This paper discusses a rare case of vaginal delivery of conjoined twins, highlighting the challenges and management options when prenatal diagnosis is not possible.

## Contribution

The paper contributes a case report of vaginal delivery of dithoracic parapagus conjoined twins, emphasizing the need for preparedness in undiagnosed cases.

## Key findings

- Vaginal delivery of conjoined twins is possible but poses significant challenges when prenatal diagnosis is absent.
- Undiagnosed conjoined twin cases at delivery may require destructive procedures due to the complexity of the condition.
- Sharing such rare cases can help improve management strategies for vaginal delivery of conjoined twins.

## Abstract

Conjoined twins (CTs) are a rare occurrence. A timely prenatal diagnosis of this anomaly by ultrasonography is crucial for counseling regarding various management options like pregnancy termination, selective feticide, or postdelivery surgical separation. However, some cases can still remain undetected until birth. We report the case of a grand multipara in her 30s who came to our labor room at 28 weeks of gestation, as an unbooked case and had vaginal delivery of dithoracic parapagus CTs, weighing 2,000 g. Although cesarean section is considered the preferred mode of delivery for CTs, undiagnosed cases presenting directly at birth, as in our instance, pose significant challenges. In extreme cases, destructive procedures may become necessary. Such cases highlight the need for preparedness during delivery. Sharing the experiences of vaginal deliveries of CTs might help in exploring the optimal approaches for trial of vaginal birth in specific scenarios.