Omfalopagus yapışık ikizlerin intrauterin ve postpartum dönem ultrasonografi ve manyetik rezonans görüntüleme bulgularının sunumu
Abstract
Yapışık ikizlik oldukça nadir görülen konjenital malformasyonlardandır. Oluşmasında herhangi bir genetik, çevresel veya demografik faktör tanımlanmamıştır. Bu fenomen fertilizasyondan sonraki 13. ve 15. günler arasındaki embriyonel bölünmedeki yetersizlik sonucu meydana gelir. İkizler, ana kaynaşma bölgesine sabit veya bağlanmış anlamına gelen pagus son ekinin eklenmesiyle adlandırılır ve sınıflandırılırlar. Omfalopagus ikizleri, yapışık ikizlerin en yaygın ikinci çeşididir ve genellikle karın bölgesinden birleşiktirler.
Olgumuzda 31 yaşındaki hamile bir kadın 22. gebelik haftasında rutin gebelik kontrolü için başvurdu. Obstetrik ultrason (US)görüntülemede karın bölgesinden yapışık iki fetüs tespit edildi. Karaciğerleri birleşmiş ancak diğer organları ayrı görünümdeydi. Renkli Doppler incelemede her iki fetüsün hepatik venleri ve portal venleri ayrı olarak izlendi. İkizler 34. gebelik haftasında sezaryen ile başarıyla doğurtuldu. Bu ogu sunumunda, bu nadir anomalinin intrauterin ve postpartum dönemdeki US ve MRG özellikleri sunulmuş ve literatüre katkı sağlamak amaçlanmıştır.
Keywords
References
- Hortu İ, Ergenoğlu AM, Yeniel AO, Özçeltik G. Neural Tube Defect with Parasitic Rachipagus Twin (Heteropagus): Case Report Turkiye Klinikleri J Gynecol Obst 2016; 26 (3): 189-92.
- Sabih D, Ahmad E, Sabih A, Sabih Q. Ultrasound diagnosis of cephalopagus conjoined twin pregnancy at 29 weeks. Biomedical Imaging and Intervention Journal 2010; 6 (4): e38.
- McHugh K, Kiely EM, Spitz L. Imaging of conjoined twins. Pediatric Radiology 2006; 36: 899–910.
- Mete A, Cebesoy FB, Bayram M, Kutlar İ. Ultrafast magnetic resonance imaging of omphalopagus conjoined twins. Gaziantep Medical Journal 2011; 17 (2): 103-4.
- Kingston C, McHugh K, Kumaradevan J, Kiely E, Spitz L. Imaging in the Preoperative Assessment of Conjoined Twins. RadioGraphics 2001; 21:1187–208.
- Abdullah H, Wahab NA, Abu Bakar K. Fetal MRI of thoraco-omphalopagus conjoined twins. BMJ Case Rep 2017; Jun 13 doi: 10.1136/bcr-2017-219793.
- Fagan CJ. Antepartum diagnosis of conjoined twins by ultrasonography. American Journal of Roentgenology 1977; 129 (5): 921-2.
- Taner MZ, Kurdoglu M, Taskiran C, Kurdoglu Z, Himmetoglu O, Balci S. Early prenatal diagnosis of conjoined twins at 7 weeks and 6 days’ gestation with two-dimensional Doppler ultrasound: a case report. Cases Journal 2009; 2: 7.
- Weiss JL, Devine PC. False positive diagnosis of conjoined twins in the first trimester. Ultrasound in Obstetrics & Gynecology 2002; 20: 516–21.
- Mutchinick OM et al. Conjoined twins: a worldwide collaborative epidemiological study of the International Clearinghouse for Birth Defects Surveillance and Research. Am J Med Genet C Semin Med Genet. 2011 (15); 157: 274-87.
Presentation of ultrasound and magnetic resonance imaging findings of omphalopagus conjoined twins in the intrauterine and postpartum period
Abstract
Conjoined twins are extremely rare congenital malformations. Any associated genetic, environmental or demographic factors have not been identified. The phenomenon occurs between the 13th and 15th day after fertilization due to failure in splitting of embrionic axis. Twins are classified according to the major site of union, with the suffix pagus meaning fixed or fastened. Omphalopagus twins are the second most common variety of conjoined twins and usually are joined at the umbilicus.
A 31-year-old pregnant female admitted for routine gestational control. Obstetric ultrasound (US) revealed two fetuses which were adherent from abdominal region. Their livers were fused however other organs were separated. Hepatic veins and portal veins were separated in both fetuses on color Doppler evaluation. Fetal magnetic resonance imaging (MRI) confirmed the diagnosis as omphalopagus conjoined twins. Twins were successfully delivered by cesarean section at 34th gestational week.
Herein, US and MRI features of this rare anomaly in intrauterine and postpartum period are presented
Keywords
References
- Hortu İ, Ergenoğlu AM, Yeniel AO, Özçeltik G. Neural Tube Defect with Parasitic Rachipagus Twin (Heteropagus): Case Report Turkiye Klinikleri J Gynecol Obst 2016; 26 (3): 189-92.
- Sabih D, Ahmad E, Sabih A, Sabih Q. Ultrasound diagnosis of cephalopagus conjoined twin pregnancy at 29 weeks. Biomedical Imaging and Intervention Journal 2010; 6 (4): e38.
- McHugh K, Kiely EM, Spitz L. Imaging of conjoined twins. Pediatric Radiology 2006; 36: 899–910.
- Mete A, Cebesoy FB, Bayram M, Kutlar İ. Ultrafast magnetic resonance imaging of omphalopagus conjoined twins. Gaziantep Medical Journal 2011; 17 (2): 103-4.
- Kingston C, McHugh K, Kumaradevan J, Kiely E, Spitz L. Imaging in the Preoperative Assessment of Conjoined Twins. RadioGraphics 2001; 21:1187–208.
- Abdullah H, Wahab NA, Abu Bakar K. Fetal MRI of thoraco-omphalopagus conjoined twins. BMJ Case Rep 2017; Jun 13 doi: 10.1136/bcr-2017-219793.
- Fagan CJ. Antepartum diagnosis of conjoined twins by ultrasonography. American Journal of Roentgenology 1977; 129 (5): 921-2.
- Taner MZ, Kurdoglu M, Taskiran C, Kurdoglu Z, Himmetoglu O, Balci S. Early prenatal diagnosis of conjoined twins at 7 weeks and 6 days’ gestation with two-dimensional Doppler ultrasound: a case report. Cases Journal 2009; 2: 7.
- Weiss JL, Devine PC. False positive diagnosis of conjoined twins in the first trimester. Ultrasound in Obstetrics & Gynecology 2002; 20: 516–21.
- Mutchinick OM et al. Conjoined twins: a worldwide collaborative epidemiological study of the International Clearinghouse for Birth Defects Surveillance and Research. Am J Med Genet C Semin Med Genet. 2011 (15); 157: 274-87.
Details
| Primary Language | English |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Case Reports |
| Authors | |
| Publication Date | December 30, 2020 |
| Submission Date | August 16, 2020 |
| Published in Issue | Year 2020Volume: 59 Issue: 4 |
