Skip to main content
SpringerLink
Log in

Anomalies of Monozygotic Duplication

  • Chapter
Pathology of Multiple Pregnancy

Abstract

Although monozygotic twins are often called “identical”, implying symmetrically distinct duplication, much of the literature on abnormalities of monozygotic twinning describes the remarkable variety of asymmetric or incomplete duplications that are encountered. These include the so-called acardius-sacephalus group, parasitic partial duplication, fetus in fetu, and the varieties of conjoined twins. Some of the most bizarre human anomalies occur in this group of conceptions and they have been the stuff of “freak shows” and museums for centuries. Public curiosity continues, and tabloid and national newspaper and magazine media regularly publish accounts of these unfortunate infants.1–3 These abnormalities are rare but they deserve close attention and documentation for the lessons in development they may provide, and the pathologist has a particular opportunity to study the anatomy and consider the pathoembryology of these fetuses and infants. An equally important role for the pathologist is to identify these often grotesque abnormalities as probably sporadic developmental “mistakes of nature” due to as yet unknown causes. Such an interpretation may help alleviate the emotional suffering of the parents and equip them to deal more effectively with family and friends. Also, it has been the author’s experience that these parents benefit greatly by discussing autopsy findings directly with the pathologist, and such discussions are encouraged in these cases particularly.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Hollobon J. Making individuals out of siamese twins. Globe and Mail. 1984; Aug 7:14.

    Google Scholar 

  2. Hluchy P. A new chance at life for siamese twins. MacLeans. 1984; Aug 13:38–42.

    Google Scholar 

  3. O’Donovan S. Tragic tale of two-headed baby has happy ending. National Examiner. 1989; Feb 7:25.

    Google Scholar 

  4. Stockard CR. Developmental rate and structural expression: an experimental study of twins, “double monsters” and single deformities, and the interaction among embryonic organs during their origin and development. AmJAnat. 1921;28:115–277.

    Google Scholar 

  5. Potter EL, Craig JM. Pathology of the Fetus and the Infant. 3rd ed. Chicago: Year Book Medical Publishers; 1975:180–197, 207–237.

    Google Scholar 

  6. De Robertis EM, Oliver G, Wright CVE. Homeobox genes and the vertebrate body plan. Sci Am. 1990;263:46–52.

    PubMed  Google Scholar 

  7. Willis RA. The Borderland of Embryology and Pathology. 2nd ed. London: Butterworths; 1962: 135–147, 442–462.

    Google Scholar 

  8. Du Plessis JPG, Winship WS, Kirstein JDL. Fetus in fetu and teratoma. South Afr Med J. 1974; 48:2119–2122.

    Google Scholar 

  9. Nadimpalli VR, Reyes H, Manaligod JR. Retroperitoneal teratoma with fetuses. Teratology. 1989; 39:233–236.

    PubMed  CAS  Google Scholar 

  10. Heifetz SA, Alrabeeah A, Brown B StJ, Lau H. Fetus in fetu: a fetoform teratoma. Pediatr Pathol. 1988;8:215–226.

    PubMed  CAS  Google Scholar 

  11. Gonzalez-Crussi F. Extragonadal teratomas. In: Atlas of Tumor Pathology? Second series, Fascicle 18. Washington, DC: Armed Forces Institute of Pathology, 1982.

    Google Scholar 

  12. Weldon-Linne CM, Rushovich AM. Benign cystic teratomas with homunculi. Obstet Gynecol. 1983; 61:88S’94S.

    Google Scholar 

  13. Lamabadusuriya SP, Atukorale AW, Soysa PE, Walpita PR. A case of fetus in fetu. Arch Dis Child . 1972;47:305–307.

    PubMed  CAS  Google Scholar 

  14. Kimmel DL, Moyer EK, Peale AR, Winborne LW, Gotwals JE. A cerebral tumor containing five human fetuses. AnatRec. 1950;106:141–165.

    CAS  Google Scholar 

  15. Knox AJS, Webb AJ. The clinical features and treatment of fetus in fetu: two case reports and review of the literature. J Pediatr Surg. 1975; 10:483–489.

    PubMed  CAS  Google Scholar 

  16. Lewis RH. Foetus in foetu and the retroperitoneal teratoma. Arch Dis Child. 1961;36:220–226.

    PubMed  CAS  Google Scholar 

  17. Edmonds HW, Hawkins JW. The relationship of twins, teratomas and ovarian dermoids. Cancer Res. 1941;1:896–899.

    Google Scholar 

  18. Vohra K, Iqbal S, Dasilva M, Sahdev S, Shahar Y, Jhaveri R. Visual diagnosis casebook: epignathus. J Perinatol. 1989;9:448–450.

    PubMed  CAS  Google Scholar 

  19. Newman A. The Illustrated Treasury of Medical Curiosa. New York: McGraw-Hill; 1988:226, 294.

    Google Scholar 

  20. Manley JL, Levine MS. The homeo box and mammalian development. Cell. 1985;43:1–2.

    PubMed  CAS  Google Scholar 

  21. Gehring WJ. The homeo box: a key to the understanding of development? Cell. 1985;43:3–5.

    Google Scholar 

  22. Gehring WJ, Hiromi Y. Homeotic genes and the homeobox. AnnuRev Genet. 1986;20:147–173.

    CAS  Google Scholar 

  23. Smith D, Majmudar B. Teratoma of umbilical cord. Hum Pathol. 1985;16:190–193.

    PubMed  CAS  Google Scholar 

  24. Fox H, Butler-Manuel R. A teratoma of the placenta. J Pathol Bact. 1964;88:137–140.

    CAS  Google Scholar 

  25. Fujikura T, Wellings SR. A teratoma like mass in the placenta of a malformed infant. Am J Obstet Gynecol. 1964;89:824–825.

    PubMed  CAS  Google Scholar 

  26. Nickell KA, Stocker JT. Placental teratoma: a case report. Pediatr Pathol. 1987;7:645–650.

    PubMed  CAS  Google Scholar 

  27. Stephens TD, Spall R, Urfer AG, Martin R. Fetus amorphus or placental teratoma? Teratology. 1989; 40:1–10.

    PubMed  CAS  Google Scholar 

  28. Kerr MG, Rashad MN. Autosomal trisomy in a discordant monozygotic twin. Nature. 1966; 212:726–727.

    Google Scholar 

  29. Gross RE, Clatworthy HW. Twin fetuses in fetu. J Pediatr. 1951;38:502–508.

    PubMed  CAS  Google Scholar 

  30. Janovski NA. Fetus in fetu. J Pediatr. 1962; 61:100–104.

    PubMed  CAS  Google Scholar 

  31. Boyce MJ, Lockyer JW, Wood CBS. Foetus in foetu: serologic assessment of monozygotic origin by automated analysis. J Clin Pathol. 1972;25: 793–798.

    PubMed  CAS  Google Scholar 

  32. Kakizoe T, Tahara M. Fetus in fetu located in the scrotal sac of a newborn infant: a case report. J Urol. 1972;107:506–508.

    PubMed  CAS  Google Scholar 

  33. Afshar F, King TT, Berry CL. Intraventricular fetus in fetu. J Neurosurg. 1982;56:845–849.

    PubMed  CAS  Google Scholar 

  34. Chi JG, Lee YS, Park YS, Chang KY. Fetus-in-fetu: report of a case. Am J Clin Pathol. 1984; 82:115–119.

    PubMed  CAS  Google Scholar 

  35. Yasuda Y, Mitomori T, Matsuura A, Tanimura T. Fetus in fetu: report of a case. Teratology. 1985; 31:337–344.

    PubMed  CAS  Google Scholar 

  36. Alpers CE, Harrison MR. Fetus in fetu associated with an undescended testis. Pediatr Pathol. 1985;4:37–46.

    PubMed  CAS  Google Scholar 

  37. Martinez-Urrutia MJ, Pereira PL, Lassaletta L, Gracia R, Utrilla J. Abdominal mass: “fetus in fetu.” Acta Pediatr Scand. 1990;79:121–122.

    CAS  Google Scholar 

  38. Omoy A, Navot D, Menashi M, Laufer N, Chemke J. Asymmetry and discordance for congenital anomalies in conjoined twins: a report of six cases. Teratology. 1980;22:145–154.

    Google Scholar 

  39. Dmt RM, Dmt R, Fontana A, Grosso JJ. Mature presacral sacrococcygeal teratoma associated with a sacral “vpign&thxis.”Pediatr Pathol. 1992;12:99–103.

    Google Scholar 

  40. Rowe MI, Ravitch MM, Ranniger K. Operative correction of caudal duplication (dipygus). Surgery. 1968;63:840–848.

    PubMed  CAS  Google Scholar 

  41. Simpson JS, Gibson DA, Cook GT. Surgical correction of caudal duplication (dipygus). J Pediatr Surg. 1973;8:935–938.

    PubMed  CAS  Google Scholar 

  42. Spitz L, Rickwood AMK, Pilling D. Dipygus (caudal duplication). J Pediatr Surg. 1979;14:557–560.

    PubMed  CAS  Google Scholar 

  43. Braun P, Addor C, Cuendet A. Surgical correction of caudal duplication. J Pediatr Surg. 1979; 14: 561–563.

    PubMed  CAS  Google Scholar 

  44. Sathiakumar N, Ifere OAS, Salawu SAI, Mbamali EI. Heteropagus: a case report. Ann Trop Pediatr. 1988;8:38–41.

    CAS  Google Scholar 

  45. Stephens TD, Siebert JR, Graham JM Jr, Beckwith JB. Parasitic conjoined twins, two cases, and their relation to limb morphogenesis. Teratology. 1982; 26:115–121.

    PubMed  CAS  Google Scholar 

  46. Yasuda Y, Ohtsuki H, Torii S, Tomoyoshi E, Clark CF. Epigastrius with oomphaloeoele—report of a case. Teratology. 1984;30:297–309.

    PubMed  CAS  Google Scholar 

  47. Takayanagi K. A rare case of caudal duplication. J Pediatr Surg. 1991;26:228–229.

    PubMed  CAS  Google Scholar 

  48. Husain AN, Muraskas J, Lambert G, Dado D, Lynch J. Parasitic conjoined twins with oomphaloeoele and tetralogy of Fallot. Pediatr Pathol. 1989;9:321–328.

    PubMed  CAS  Google Scholar 

  49. Silbermann M, Bar-Maor JA, Auslander L. Craniofacial microsomia in a parasite of a heteropagus conjoined twin: a clinical and histopathologic evaluation, Head Neck Surg. 1984;6:792–800.

    PubMed  CAS  Google Scholar 

  50. Antunes JL, Sharer LR, Pellock JM. Occipital encephalocoele—a case of conjoined twinning? Neurosurgery. 1983;13:703–707.

    PubMed  CAS  Google Scholar 

  51. Chen W-J, Chen K-M, Chen M-T, Liu T-K, Chu S-H, Tsai FC, Hwang F-Y. Emergency separation of omphaloischiopagus tetrapus conjoined twins in the newborn period. J Pediatr Surg. 1989;24: 1221–1224.

    PubMed  CAS  Google Scholar 

  52. Barr M Jr. Facial duplication: case, review and embryogenesis. Teratology. 1982;25:153–159.

    PubMed  Google Scholar 

  53. Chervenak FA, Pinto MM, Heller CI, Norooz H. Obstetric significance of fetal craniofacial duplication. A case report. J Reprod Med. 1985;30:74–76.

    PubMed  CAS  Google Scholar 

  54. Amatuzio JC, Gorlin RJ. Conjoined acardiac monsters. Arch Pathol Lab Med. 1981;105:253–255.

    PubMed  CAS  Google Scholar 

  55. Napolitani FD, Schreiber I. The acardiac monster. A review of the world literature and presentation of 2 cases. Am J Obstet Gynecol. 1960;80:582–589.

    PubMed  CAS  Google Scholar 

  56. Warkany J. Congenital Malformations. Chicago: Year Book Medical Publishers; 1971:474.

    Google Scholar 

  57. Lindahl SA, Baldwin VJ, Wakeford J, Wittmann BK. Early diagnosis of an acardiac acephalus twin by ultrasound. Med Ultrasound. 1984;8:105–107.

    Google Scholar 

  58. Fox H. Pathology of the Placenta. Vol 7. Major Problems in Pathology, Bennington JL, ed. London: WB Saunders; 1978:73–94.

    Google Scholar 

  59. Sanfilippo J, Bianchine JQ, Walsh A, Badawy S. Acardius myelacephalus. Two monsters in a triplet pregnancy. NY State J Med. 1979;79:P245–247.

    Google Scholar 

  60. Simonds JP, Go wen G A. Fetus amorphus (report of a case). Surg Gynecol Obstet. 1925;41:171–179.

    Google Scholar 

  61. Sato T, Kaneko K, Konuma S, Sato I, Tamada T. Acardiac anomalies: review of 88 cases in Japan. Asia Oceana J Obstet Gynecol. 1984;10:45–52.

    CAS  Google Scholar 

  62. Auerback P, Wiglesworth FW. Congenital absence of the heart: observation of a human funiculopagus twinning with insertiofuniculi furcata, fusion, forking and interposito velamentosa. Teratology. 1978;17:143–150.

    Google Scholar 

  63. van Allen MI. Fetal vascular disruptions: mechanisms and some resulting birth defects. Pediatr Ann. 1981;10:219–233.

    PubMed  Google Scholar 

  64. Stephens TD. Muscle abnormalities associated with the twin-reversed-arterial-perfusion (TRAP) sequence (acardia). Teratology. 1984;30:311–318.

    PubMed  CAS  Google Scholar 

  65. Ketchum J, Motyloff L. Chorangiopagus parasiticus (Schwalbe). Report of a case of acardius acephalus and of a case of fetus amorphus. Am J Obstet Gynecol. 1957;73:1349–1354.

    PubMed  CAS  Google Scholar 

  66. Price B. Primary biases in twin studies—a review of prenatal and natal difference-producing factors in monozygotic pairs. Am J Hum Genet. 1950; 2:293–352.

    PubMed  CAS  Google Scholar 

  67. Severn CB, Holyoke EA. Human acardiac anomalies. Am J Obstet Gynecol. 1973;116:358–365.

    PubMed  CAS  Google Scholar 

  68. Kyriazis A, Arean VM, Shanklin DR. Placental-radiographic analysis of parasitic acardiac fetus: partially common umbilical circulation. J Reprod Med. 1974;12:74–81.

    PubMed  CAS  Google Scholar 

  69. Benirschke K, Des Roches Harper V. The acardiac anomaly. Teratology. 1977;15:311–316.

    PubMed  CAS  Google Scholar 

  70. Kaplan C, Benirschke K. The acardiac anomaly. New case reports and current status. Acta Genet Med Gemellol. 1979;28:51–59.

    PubMed  CAS  Google Scholar 

  71. Deacon JS, Machin GA, Martin JME, Nicholson S, Nwankwo DC, Wintemute R. Investigation of acephalus. Am J Med Genet. 1980;5:85–99.

    PubMed  CAS  Google Scholar 

  72. Scott JM, Ferguson-Smith MA. Heterokaryotypic monozygotic twins and the acardiac monster. J Obstet Gynecol Br Cwlth. 1973;80:52–59.

    CAS  Google Scholar 

  73. Wolf HK, MacDonald J, Bradford WB, Lahman JT. Acardius anceps with evidence of intrauterine vascular occlusion: report of a case and discussion of pathogenesis. Pediatr Pathol. 1991;11:143–152.

    PubMed  CAS  Google Scholar 

  74. van Allen MI, Smith DW, Shepard TH. Twin reversed arterial perfusion (TRAP) sequence: a study of 14 twin pregnancies with acardius. Semin Perinatol. 1983;7:285–293.

    PubMed  Google Scholar 

  75. Moore CA, Buehler BA, McManus BM, Harmon JP, Mirkin LD, Goldstein DJ. Brief clinical report: acephalus-acardia in twins with aneuploidy. Am J Med Genet Suppl. 1987;3:139–143.

    PubMed  CAS  Google Scholar 

  76. Bhatnagar KP, Sharma SC, Bisker J. The holoacardius: a correlative computerized tomographic, radiologic, and ultrasonographic investigation of a new case with review of literature. Acta Genet Med Gemellol. 1986;35:77–89.

    PubMed  CAS  Google Scholar 

  77. Bieber FR, Nance WE, Morton CC, Brown JA, Redwine FO, Jordan RL, Mohanakumar T. Genetic studies of an acardiac monster: evidence of polar body twinning in man. Science. 1981, 213: 775–777.

    PubMed  CAS  Google Scholar 

  78. Campbell M, Shepherd HD. The circulatory and anatomical abnormalities of an acardiac fetus of rare form. Lancet. 1905;Sept 30:941–944.

    Google Scholar 

  79. Leroy F. Major fetal hazzards in multiple pregnancy. Acta Genet Med’Gemellol. 1976;25:299–306.

    CAS  Google Scholar 

  80. Gessner IH. Spectrum of congenital cardiac anomalies produced in chick embryos by mechanical interference with cardiogenesis. Circ Res. 1966; 18:625–633.

    PubMed  CAS  Google Scholar 

  81. Keith L. Holoacardius. 7 Reprod Med. 1974; 12:82–85.

    CAS  Google Scholar 

  82. Nerlich A, Wisser J, Draeger A, Nathrath W, Remberger K. Human acardiac anomaly: a report of three cases. Eur J Obstet Gynecol Reprod Biol. 1990;38:79–85.

    Google Scholar 

  83. Svejda J. A case of foetus pseudo-amorphus. J Pathol Bact. 1947;59:647–655.

    CAS  Google Scholar 

  84. Gewolb IH, Freedman RM, Kleinman CS, Hobbins JC. Prenatal diagnosis of a human pseudoacardiac anomaly. Obstet Gynecol. 1983;61:657–662.

    PubMed  CAS  Google Scholar 

  85. James WH. A note on the epidemiology of acardiac monsters. Teratology. 1978;16:211–216.

    Google Scholar 

  86. Benirschke K, Driscoll SG. The Pathology of the Human Placenta. New York: Springer-Verlag; 1967:166–168.

    Google Scholar 

  87. Draeger A, Nerlich A. Syndrome des bandes amni-otiques associe a une malformation acardiaque observe dans une grossesse gemellaire. A propos d’un cas. Ann Pathol. 1988;8:317–320.

    PubMed  CAS  Google Scholar 

  88. Benirschke K. Lessons from multiple pregnancies in mammals. In: Gedda L, Parisi P, Nance WE, eds. Twin Research 3: Twin Biology and Multiple Pregnancy. Prog Clin Biol Res. 1981;69A: 135- 139.

    Google Scholar 

  89. Richart R, Benirschke K. Holoacardius amorphus. Report of a case with chromosomal analysis. Am J Obstet Gynecol. 1963;86:329–332.

    PubMed  CAS  Google Scholar 

  90. Imai A, Hirose R, Kawabata I, Tamaya T. Acardiac acephalic monster extremely larger than the co-twin. A case report. Gynecol Obstet Invest. 1991;32:62–64.

    PubMed  CAS  Google Scholar 

  91. Lachman R, McNabb M, Furmanski M, Karp L. The acardiac monster. Eur J Pediatr. 1980; 134: 195–200.

    PubMed  CAS  Google Scholar 

  92. Genest DR, Lage JM. Absence of normal-appearing proximal tubules in the fetal and neonatal kidney: prevalence and significance. Hum Pathol. 1991;22:147–153.

    PubMed  CAS  Google Scholar 

  93. Weissberg SM. Fetus acardius. J Reprod Med. 1974;12:71–73.

    PubMed  CAS  Google Scholar 

  94. Harkavy KL, Scanlon JW. Hydrops fetalis in a parabiotic acardiac twin. Am J Dis Child. 1978; 132:638–639.

    Google Scholar 

  95. Royston D, Geoghegan F. Disseminated arterial calcification associated with acardius acephalus. Arch Dis Child. 1983;58:641–643.

    PubMed  CAS  Google Scholar 

  96. Popek EJ, Strain JD, Neumann A, Wilson H. In utero development of pulmonary artery calcification in monochorionic twins: report of three cases (Abstract). Mod Pathol. 1990;3:7P. (Poster—Society for Pediatric Pathology, Boston 1990).

    Google Scholar 

  97. Schinzel AAGL, Smith DW, Miller JR. Monozygotic twinning and structural defects. J Pediatr. 1979;95:921–930.

    PubMed  CAS  Google Scholar 

  98. Billah KL, Shah K, Odwin C. Ultrasound diagnosis and management of acardius anencephalic twin pregnancy. Med Ultrasound. 1984;8:108–109.

    Google Scholar 

  99. Stiller RJ, Romero R, Pace S, Hobbins JC. Prenatal identification of twin reversed arterial perfusion syndrome in the first trimester. Am J Obstet Gynecol. 1989;160:1194–1196.

    PubMed  CAS  Google Scholar 

  100. Gibson JY, D’Cruz CA, Patel RB, Palmer SM. Acardiac anomaly: review of the subject with case report and emphasis on practical sonography. J Clin Ultrasound. 1986;14:541–545.

    PubMed  CAS  Google Scholar 

  101. Kirkinen P, Herva R, Räsänen J, Airaksinen J, Ikaheimo M. Documentation of paradoxical umbilical blood supply of an acardiac twin in the antepartum state. J Perinat Med. 1989;17:63–65.

    PubMed  CAS  Google Scholar 

  102. Benson CB, Bieber FR, Genest DR, Doubilet PM. Doppler demonstration of reversed umbilical blood flow in an acardiac twin. J Clin Ultrasound. 1989;17:291–295.

    PubMed  CAS  Google Scholar 

  103. Sherer DM, Armstrong B, Shah YG, Metlay LA, Woods JR Jr. Prenatal sonographic diagnosis, Doppler velocimetric umbilical cord studies and subsequent management of an acardiac twin pregnancy. Obstet Gynecol. 1989;74:472–475.

    PubMed  CAS  Google Scholar 

  104. Harger JH, Doshi N, Marchese S, Hinkle RS, Garver KL. Increased amnionic fluid alpha-feto- protein due to a holoacardius amorphus twin. Clin Genet. 1981;19:257–261.

    PubMed  CAS  Google Scholar 

  105. Read AP, Donnai D, Tracey J, Fennell SJ. Increased amniotic alphafetoprotein due to a holoacardius amorphus twin. Clin Genet. 1982;21:382- 383.

    PubMed  CAS  Google Scholar 

  106. Moore TR, Gale S, Benirschke K. Perinatal outcome of forty-nine pregnancies complicated by acardiac twinning. Am J Obstet Gynecol. 1990;163:907–912.

    PubMed  CAS  Google Scholar 

  107. Simpson PC, Trudinger BJ, Walker A, Baird PJ. The intrauterine treatment of fetal cardiac failure in a twin pregnancy with an acardiac, acephalic monster. Am J Obstet Gynecol. 1983;147:842–844.

    PubMed  CAS  Google Scholar 

  108. Ash K, flarman CR, Gritter H. TRAP sequence- successful outcome with indomethacin treatment. Obstet Gynecol. 1990;76:960–962.

    PubMed  CAS  Google Scholar 

  109. Thomas B, Buderus S, Gembruch U. Is the’safety’ of indomethacin treatment of polyhydramnios in the mother to be questioned? (Abstract). Fetal DiagnTher. 1991;6:174.

    Google Scholar 

  110. Platt LD, DeVore GR, Bieniarz A, Benner P, Rao R. Antenatal diagnosis of acephalus acardia: a proposed management scheme. Am J Obstet Gynecol. 1983;146:857–859.

    PubMed  CAS  Google Scholar 

  111. Porrero RP, Barton SM, Haverkamp AD. Occlusion of umbilical artery in acardiac acephalic twin. Lancet 1991;337:326–327.

    Google Scholar 

  112. Robie GF, Payne GG, Morgan MA. Selective delivery of an acardiac acephalic twin. N Engl J Med. 1989;320:512–513.

    PubMed  CAS  Google Scholar 

  113. Fries MH, Goldberg JD, Golbus MS. Treatment of acardiac-acephalus twin gestation by hysterotomy and selective delivery. Obstet Gynecol. 1992;79: 601–604.

    PubMed  CAS  Google Scholar 

  114. Ginsberg NA, Applebaum M, Rabin SA, Caffarelli MA, Kuuspalu M, Daskal JL, Verlinsky Y, Strom CM, Barton JJ. Term birth after midtrimester hysterotomy and selective delivery of an acardiac twin. Am J Obstet Gynecol. 1992;167:33–37.

    PubMed  CAS  Google Scholar 

  115. Benirschke K. The pathophysiology of the twinning process. In: Iffy L, Kaminetzky HA, eds. Principles and Practice of Obstetrics and Perinatology. New York: John Wiley; 1981:1165–1170.

    Google Scholar 

  116. Shaw CE. Split personality. The two-headed snake. Zoonooz. 1954;27:4.

    Google Scholar 

  117. The strangest thing. The Globe and Mail. 1986; Sept 24:48.

    Google Scholar 

  118. Warkany J. Congenital Malformations. Chicago: Year Book Medical Publishers; 1971:6–9.

    Google Scholar 

  119. Gedda L. Twinning in History and Science. Springfield: Charles C Thomas; 1961:106–118.

    Google Scholar 

  120. Newman HH. Multiple Human Births. New York: Doubleday, Doran; 1940:60–74.

    Google Scholar 

  121. Guttmacher AF. Biographical notes on some famous conjoined twins. Birth Defects. 1967;3(1): 10–17.

    Google Scholar 

  122. Annas GJ. Siamese twins: killing one to save the other. Hastings Cent Rep. 1987;17:27–29.

    PubMed  CAS  Google Scholar 

  123. Pepper CK. Ethical and moral considerations in the separation of conjoined twins. Birth Defects. 1967;3(1): 128–134.

    Google Scholar 

  124. Votteler TP. Conjoined twins. In: Welch KJ, Randolph JG, Ravich MM, O’Neill JA, Rowe MI, eds. Pediatric Surgery. 4th ed. Vol 2. Chicago: Year Book Medical Publishers; 1986:771–779.

    Google Scholar 

  125. Nichols BL, Blattner RJ, Rudolph AJ. General clinical management of thoracopagus twins. Birth Defects. 1967;3(1):38–51.

    Google Scholar 

  126. Ripman HA. Conjoined twins as an obstetric problem. Guy’s Hosp Rep. 1958;107:173–184.

    CAS  Google Scholar 

  127. Maggio M, Callan NA, Hamod KA, Sanders RC. The first trimester ultrasonographic diagnosis of conjoined twins. Am J Obstet Gynecol. 1985; 152:833–835.

    PubMed  CAS  Google Scholar 

  128. Turner RJ, Hankins GDU, Weinreb JC, Ziaya PR, Davis TN, Lowe TW, Gilstrap LC. Magnetic resonance imaging and ultrasonography in the antenatal evaluation of conjoined twins. Am J Obstet Gynecol. 1986;155:645–649.

    PubMed  CAS  Google Scholar 

  129. Sanders SP, Chin AJ, Parness IA, Benacerraf B, Greene MF, Epstein MF, Colan SD, Frigoletto FD. Prenatal diagnosis of congenital heart defects in thoracoabdominally conjoined twins. N Engl J Med. 1985;313:370–374.

    PubMed  CAS  Google Scholar 

  130. Sakala EP. Obstetric management of conjoined twins. Obstet Gynecol. 1986;67:21S-25S.

    PubMed  CAS  Google Scholar 

  131. Filler RM. Conjoined twins and their separation. SeminPerinatol. 1986;10:82–91.

    CAS  Google Scholar 

  132. O’Neill JA, Holcomb GW, Schnaufer L, Templeton JM, Bishop HC, Ross AJ, Duckett JW, Norwood WI, Ziegler MM, Koop CE. Surgical experience with thirteen conjoined twins. Ann Surg. 1988;208:299–312.

    PubMed  Google Scholar 

  133. Bergsma D, Blattner RJ, Nichols BL, Rudolph AJ. Conjoined twins. Birth Defects. 1967;3(1):1–147.

    Google Scholar 

  134. Viljoen DL, Nelson MM, Beighton P. The epidemiology of conjoined twinning in southern Africa. Clin Genet. 1983;24:15–21.

    PubMed  CAS  Google Scholar 

  135. Rudolph AJ, Michaels JP, Nichols BL. Obstetric management of conjoined twins. Birth Defects. 1967;3(1):28–57.

    Google Scholar 

  136. Benirschke K, Kim CK. Multiple pregnancy. N Engl J Med. 1973;288:1276–1284, 1329–1336.

    PubMed  CAS  Google Scholar 

  137. Myrianthopoulos MC. Congenital malformations in twins: epidemiologic survey. Birth Defects. 1975;11(8):1–39.

    CAS  Google Scholar 

  138. Edmunds LD, Layde PM. Conjoined twins in the United States, 1970–1977. Teratology. 1982;25: 301–308.

    Google Scholar 

  139. Imaizumi Y. Conjoined twins in Japan, 1979- 1985. Acta Genet Med Gemellol. 1988;37:339- 345.

    PubMed  CAS  Google Scholar 

  140. Kállén B, Rybo G. Conjoined twinning in Sweden. Acta Genet Med Gemellol. 1978;57:257–259.

    Google Scholar 

  141. Métneki J, Czeuzel A. Conjoined twins in Hungary, 1970–1986. Acta Genet Med Gemellol. 1989;38:285–299.

    PubMed  Google Scholar 

  142. Tan KL, Goon SM, Salmon Y, Wee JH. Conjoined twins. Acta Obstet Gynecol Scand. 1971;50:373- 380.

    PubMed  CAS  Google Scholar 

  143. Emanuel I, Huang SW, Gutman LT, Yu FC, Linn CC. The incidence of congenital malformations in a Chinese population: The Taipei collaborative study. Teratology. 1972;5:159–169.

    PubMed  CAS  Google Scholar 

  144. Tan K-L, Tock EPC, Dawood MY, Ratnam SS. Conjoined twins in a triplet pregnancy. Am J Dis Child. 1971;122:455–458.

    PubMed  CAS  Google Scholar 

  145. Aird I. Conjoined twins—further observations. Br Med J. 1959;1:1313–1315.

    PubMed  CAS  Google Scholar 

  146. Jaschevatzky OE, Goldman B, Kampf D, Wexler H, Grunstein S. Etiologic aspects of double monsters. Eur J Obstet Gynecol Reprod Biol. 1980;10:343–349.

    PubMed  CAS  Google Scholar 

  147. Hamon A, Dinno N. Dicephalus dipus tribrachius conjoined twins in a female infant. Birth Defects. 1978;14(6A):213–218.

    PubMed  CAS  Google Scholar 

  148. Milham S Jr. Symmetrical conjoined twins: an analysis of the birth records of twenty-two sets. J Pédiatr. 1966;69:643–647.

    PubMed  Google Scholar 

  149. Offringa PJ, Wildschut HI J, Tutein Nolthenius-Puylaert MCBJE, Leon S, Boersma ER. Conjoined twins and abdominal pregnancy. Int J Gynecol Obstet. 1989;30:73–76.

    CAS  Google Scholar 

  150. Benirschke K, Temple WW, Bloor CM. Conjoined twins: nosology and congenital malformations. Birth Defects. 1978;14(6A): 179–192.

    PubMed  CAS  Google Scholar 

  151. Rosa FW. Twins, conjoined, teratogenicity. In: Buyse ML, ed. Birth Defects Encyclopedia. Cambridge, MA: Blackwell Scientific; 1990:1721–1722.

    Google Scholar 

  152. Guttmacher AF, Nichols BL. Teratology of conjoined twins. Birth Defects. 1967;3(l):3–9.

    Google Scholar 

  153. Ingalls TH, Bazemore MK. Prenatal events antedating the birth of thoracopagus twins. Arch Environ Health. 1969;19:358–364.

    PubMed  CAS  Google Scholar 

  154. Zimmerman AA. Embryologic and anatomic consideration of conjoined twins. Birth Defects. 1967;3:18–27.

    Google Scholar 

  155. Herring SW, Rowlatt UF. Anatomy and embryology in cephalothoracopagus twins. Teratology. 1981;23:159–173.

    PubMed  CAS  Google Scholar 

  156. Machin GA, Sperber GH. Invited editorial comment: lessons from conjoined twins. Am J Med Genet. 1987;28:89–97.

    PubMed  CAS  Google Scholar 

  157. Spencer R. Conjoined twins: theoretical embryo- logic basis. Teratology. 1992;29:181–184.

    Google Scholar 

  158. Singer DB, Rosenberg HS. Pathologic studies of thoracopagus conjoined twins. Birth Defects. 1967;3(1):97–105.

    Google Scholar 

  159. Marin-Padilla M, Chin AJ, Marin-Padilla TM. Cardiovascular abnormalities in thoracopagus twins. Teratology. 1981;23:101–113.

    PubMed  CAS  Google Scholar 

  160. Grosse B. Siamese twins bom pregnant. Sun. 1989;7(47):1, 17.

    Google Scholar 

  161. Seo JW, Lee YS, Chi JG. Cross-sectional illustration on major types of conjoined twins. J Korean MedSci. 1988;3:19–25.

    CAS  Google Scholar 

  162. Merwin MC, Wright J. Lateral cephalothoracopagus: a case report. Teratology. 1984;29:181–184.

    PubMed  CAS  Google Scholar 

  163. Harper RG, Kenigsberg K, Sia CG, Horn D, Stem D, Bongiovi V. Xiphopagus conjoined twins: a 300-year review of the obstetric, morphopatho- logic, neonatal and surgical parameters. Am J Obstet Gynecol. 1980;137:617–629.

    PubMed  CAS  Google Scholar 

  164. Ursell PC, Wigger HJ. Asplenia syndrome in conjoined twins: a case report. Teratology. 1983;27:301–304.

    PubMed  CAS  Google Scholar 

  165. Zake EZN. Case reports of 16 sets of conjoined twins from a Uganda hospital. Acta Genet Med Gemellol. 1984;33:75–80.

    PubMed  CAS  Google Scholar 

  166. Little J, Bryan EM. Congenital Anomalies. In: MacGillivray I, Campbell DM, Thompson B, eds. Twinning and Twins. Chichester: John Wiley; 1988:213–217.

    Google Scholar 

  167. Delprado WJ, Baird PJ. Cephalothoracopagus syn- cephalus: a case report with previously unreported anatomical abnormalities and chromosomal analysis. Teratology. 1984;29:1–9.

    PubMed  CAS  Google Scholar 

  168. Baron BW, Shermeta DW, Ismail MA, Ben-Ami T, Yousefzadeh D, Carlson N, Amarose AP, Esterley JR. Unique anomalies in cephalothoracopagus janiceps conjoined twins with implications for multiple mechanisms in the abnormal embryogenesis. Teratology. 1990;41:9–22.

    PubMed  CAS  Google Scholar 

  169. Winston KR, Rockoff MA, Mulliken JB, Strand RD, Murray JE. Surgical division of craniopagi. Neurosurgery. 1987;21:782–791.

    PubMed  CAS  Google Scholar 

  170. Bucholz RD, Yoon K-W, Shively RE. Temporoparietal craniopagus. Case report and review of the literature. J Neurosurg. 1987;66:72–79.

    PubMed  CAS  Google Scholar 

  171. Konstantinova BL. Morphological and cytogenetic studies on conjoined twins. Acta Genet Med GemelloL 1976;25:55–58.

    PubMed  CAS  Google Scholar 

  172. Siebert JR, Machin GA, Sperber GH. Anatomic findings in dicephalic conjoined twins: implications for morphogenesis. Teratology. 1989;40:305–310.

    PubMed  CAS  Google Scholar 

  173. Gupta JM. Pyopagus conjoined twins. Br Med J. 1966;2:868–871.

    PubMed  CAS  Google Scholar 

  174. Albert MC, Drummond DS, O’Neill J, Watts H. The orthopedic management of conjoined twins: a review of 13 cases and report of 4 cases. J Pediatr Orthop. 1992;2:300–307.

    Google Scholar 

  175. Wiegenstein L, Iozzo RV. Unusual findings in a conjoined (“Siamese”) twin placenta. Am J Obstet Gynecol. 1980;137:744–745.

    PubMed  CAS  Google Scholar 

  176. Bardawil WA, Reddy RL, Bardawil LW. Placental considerations in multiple pregnancy. Clin Perina- tol. 1988;15(1):28.

    Google Scholar 

  177. Leachman RD, Latson JR, Kohler CM, McNamara DG. Cardiovascular evaluation of conjoined twins. Birth Defects. 1967;3(l):52–65.

    Google Scholar 

  178. Izukawa T, Kidd BSL, Moes CAF, Tyrrell MJ, Ives EJ, Simpson JS, Shandling B. Assessment of the cardiovascular system in conjoined thoracopagus twins. Am J Dis Child. 1978;132:19–24.

    PubMed  CAS  Google Scholar 

  179. Gerlis LM, Seo J-W, Ho SY, Chi JEG. Morphology of the cardiovascular system in conjoined twins: spatial and sequential segmental arrangements in 36 cases. Teratology. 1993;47:91–108.

    PubMed  CAS  Google Scholar 

  180. Seo JW, Shin SS, Chi JG. Cardiovascular system in conjoined twins: an analysis of 14 Korean cases. Teratology. 1985;32:151–161.

    PubMed  CAS  Google Scholar 

  181. Walton JM, Gillis DA, Giacomantonio JM, Hayashi AH, Lau HYC. Emergency separation of conjoined twins. J Pediatr Surg. 1991;26:1337- 1340.

    PubMed  CAS  Google Scholar 

  182. Weston PJ, Ives EJ, Honore RLH, Lees GM, Sinclair DB, Schiff D. Monochorionic diamniotic minimally conjoined twins: a case report. Am J Med Genet. 1990;37:558–561.

    PubMed  CAS  Google Scholar 

  183. Rajadurai VS, Matthai J, Judhau MA. Omphalopagus twins and twin transfusion syndrome. Indian J Pediatr. 1988;55:811–816.

    PubMed  CAS  Google Scholar 

  184. Wedberg R, Kaplan C, Leopold G, Porreco R, Renik R, Benirschke K. Cephalothoracopagus (Janiceps) twinning. Obstet Gynecol. 1979;54: 392–396.

    PubMed  CAS  Google Scholar 

  185. Riccardi VM, Bergmann CA. Anencephaly with incomplete twinning (diprosopus). Teratology. 1977;16:137–140.

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pathology, British Columbia’s Children’s Hospital, 4480 Oak Street, V6H 3V4, Vancouver, B.C., Canada

    Virginia J. Baldwin M.D.

Authors
  1. Virginia J. Baldwin M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

Copyright information

© 1994 Springer-Verlag New York Inc

About this chapter

Cite this chapter

Baldwin, V.J. (1994). Anomalies of Monozygotic Duplication. In: Pathology of Multiple Pregnancy. Springer, New York, NY. https://doi.org/10.1007/978-1-4613-9514-0_10

Download citation

  • DOI: https://doi.org/10.1007/978-1-4613-9514-0_10

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4613-9516-4

  • Online ISBN: 978-1-4613-9514-0

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation