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Successful Induction of Labor of Late–Second-Trimester Conjoined Twins: An Alternative to Hysterotomy

Mitchell, Timothy MD; Cheng, Edith MD; Jolley, Jennifer MD; Delaney, Shani MD

doi: 10.1097/AOG.0000000000000038
Case Report

BACKGROUND: To demonstrate that vaginal delivery is a safe alternative to hysterotomy when planning pregnancy termination of late–second-trimester conjoined twins. We present two cases of conjoined twins in the late second trimester desiring pregnancy termination.

CASE: The first case involved a multiparous 29-year-old woman at 23 6/7 weeks of gestation with thoraco-omphalopagus conjoined twins. The second case involved an 18-year-old primigravid woman at 25 1/7 weeks of gestation with pyopagus conjoined twins. Both desired pregnancy termination and to avoid hysterotomy. Inductions were initiated with Laminaria and augmented with vaginal misoprostol or oxytocin. Both patients had uncomplicated vaginal deliveries of intact conjoined twins without significant maternity morbidity.

CONCLUSION: Induction of labor and vaginal delivery can be a safe method for late–second-trimester termination of pregnancies with conjoined twins.

Induction of labor is a safe option for delivery of late–second-trimester conjoined twins.

Department of Obstetrics and Gynecology, University of Washington, Seattle, Washington.

Corresponding author: Timothy Mitchell, MD, University of Washington, 1959 NE Pacific Street, Box 356460, Seattle, WA 98195-6460; e-mail:

Financial Disclosure The authors did not report any potential conflicts of interest.

© 2014 by The American College of Obstetricians and Gynecologists.