A gravida 0, para 0, 27-year-old pregnant woman with an unusually large belly at 30 weeks' gestation underwent abdominal ultrasound (Figs 1 and 2). A multiple pregnancy was suspected.
Denouement and Discussion
Thoracoomphalopagus Twins With Big Omphalocele
At a gestational age of 30 weeks, prenatal ultrasonographic diagnosis of thoracoomphalopagus twins was made. They were suspected of having a single heart and an omphalocele. At 34 weeks' gestation, twins were delivered by cesarean section. In the delivery room, the infants were apneic and cyanotic. They were intubated immediately and were ventilated with positive pressure. The combined body weight of the twins was 2280 g; they faced each other and were conjoined at the distal half of the thorax and proximal two thirds of the abdomen. On initial physical examination, twin A had lordosis and a tracheoesophageal fistula, and twin B had kyphosis as well as a left diaphragmatic hernia. The twins