Successful Termination of Conjoined Twins in the Second Trimester: A Case Report

TL;DR

A case of conjoined twins at 19 weeks gestation was successfully terminated using a combination of medical and surgical procedures.

Contribution

This case report highlights a successful termination of conjoined twins in the second trimester using a combined medical and surgical approach.

Findings

Surgical evacuation following medical abortion successfully terminated conjoined twins at 19 weeks gestation.

Cervical ripening with misoprostol and revision curettage were effective in removing residual tissue.

The patient was discharged without complications, demonstrating the feasibility of this approach.

Abstract

We report a case of 19-week gestation thoracic-omphalopagus conjoined twins successfully terminated via surgical evacuation following medical abortion. A 32-year-old woman (G2P1) was referred to Umraniye Training and Research Hospital for pregnancy termination after the diagnosis of conjoined twins. Following the family's decision, cervical ripening was achieved with misoprostol. After the medical abortion, a revision curettage was performed to remove residual placental tissue and fetal membranes. The patient was discharged the following day without complications. Conjoined twins are rare and generally associated with a poor prognosis. Although early terminations are typically uncomplicated, advancing gestational age increases maternal morbidity and may require cesarean delivery for termination.

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