1. Conjoined twins By: Giselle Ilada

2. What are conjoined twins? They normally have the same sex and develop from the same fertilized egg. These twins also share the same amniotic cavity and placenta. Regular twinning occurs in two ways: 1.Woman releases two eggs instead of one and both are fertilized by separate sperm 2.Woman produces one egg that divides after fertilization Conjoined twins, however, occur when a woman produces an egg which doesn’t fully separate after fertilization. As a result, the egg develops into a conjoined fetus.

3. Types of Conjoined Twins Thoracopagus: joined at the upper chest Omphalagus: joined at the abdomen Xiphopagus: joined at part of the sternum Ischiopagus: joined at the front pelvis and sacrum Ischio-omphalopagus: combination of ischiopagus and omphalopagus, with spines joined in a “Y” shape Parapagus: joined side-by-side at the torso Dicephalus: a subset of parapagus Cranipagus: joined by a portion of the skull Cephalogus: joined at the neck and head Cephalothoracopagus: combination of cephalopagus and thoracopagus Diprosopus: two faces on a single head Pygopagus: joined back to back at the pelvis and sacrum Rachipagus: joined back to back on the lumbar spine

4. Thoracopagus The most common type and occurs 35% of all cases Joins the upper chest from the clavicle to the sternum, each with their own heads arms and legs Some share a single malformed heart, others have separate hearts Therefore separation is really risky and both twins often die Ruthie and Verena Cady are thoracopagus twins who lived until the age of seven. Before their death, there were healthy girls who enjoyed riding a tricycle, swimming, and doing gymnastics. They shared a hearth with three chambers.

5. Dicephalus Abigail and Brittany Hensel (1990- ) are dicephalic twins A lot of their vital organs are doubled up, each having their own heart, stomach, and spinal cord Each can control their half of the body. Therefore, as infants, the physical process required the cooperation of both. Now they are able to walk, run, type on a keyboard, and drive a car. At birth, they had an arm attached to a shoulder blade at the back. At age 12, they had surgery to expand their chest cavity to prevent breathing difficulties. Their parents denied the separation process since it wasn’t likely that both would survive.

6. Craniopagus Twins joined by a portion of the skull, even though they have separate necks and bodies Separation is very risky because they both share parts of the brain and even blood circulation. http://nymag.com/nymetro/health/features/12470/ Clarence and Carl Aguirre were born in April 21, 2002. They were brought to the U.S. in 2003. During the surgical process, the surgeons chose to separate them in a series of smaller operations to allow the twins to recuperate. First, they inserted tissue expanders, pouches filled with saline, under their scalps. This creates more skin that can be used to cover their wounds. The rest of the process was to slowly separate the joined brain and skull.

7. Ischiopagus Lakshmi Tatama was born in 2005 in India. She was one pair of the ischiopagus twins. The other was headless because the head and chest were underdeveloped. She was named Lakshima after the multi-limbed Hindu goddess of wealth. Sometimes she became the object of worship. It took a team of more than 30 surgeons and 27 hours to separate the twins. She had a 75-85% chance of surviving. After the surgery, she still needed other operations for her legs, pelvic muscles, and scoliosis.

8. General Problems There are many complications such as dealing with separation surgery or the death of either twin. A lot is considered in a separation surgery such as: the parents’ opinions, their quality of life, price, and success after surgery