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Tue, Feb 24, 2026
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Fatemeh Hosseinzadeh1 
, Atoosa Etezadi1 , Reihaneh Einollahzadeh2 , Zahra Khoshnoudi2 , Seyedeh Somayeh Sayad Noori2 , Samaneh Ghazanfar Tehran *3 , Gelareh Biazar2
, Atoosa Etezadi1 , Reihaneh Einollahzadeh2 , Zahra Khoshnoudi2 , Seyedeh Somayeh Sayad Noori2 , Samaneh Ghazanfar Tehran *3 , Gelareh Biazar2
1- Department of Obstetrics and Gynecology, Reproductive Health Research Center, Al-Zahra Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
2- Department of Anesthesiology, Anesthesiology Research Center, Al-Zahra Hospital, Guilan University of Medical Sciences, Rasht, Iran
3- Department of Anesthesiology, Anesthesiology Research Center, Al-Zahra Hospital, Guilan University of Medical Sciences, Rasht, Iran. Email: tehranisamaneh88rasht@gmail.com
2- Department of Anesthesiology, Anesthesiology Research Center, Al-Zahra Hospital, Guilan University of Medical Sciences, Rasht, Iran
3- Department of Anesthesiology, Anesthesiology Research Center, Al-Zahra Hospital, Guilan University of Medical Sciences, Rasht, Iran. Email: tehranisamaneh88rasht@gmail.com
Abstract: (40 Views)
Abstract
Introduction: This case report underscores the critical importance of early and accurate prenatal care in identifying serious
fetal anomalies, such as conjoined twins (CT), which can significantly impact maternal and fetal outcomes. The failure to
provide standard prenatal care not only led to a missed opportunity for early diagnosis but also resulted in a late-term cesarean
delivery that inflicted considerable psychological trauma on the mother.
Case Presentation: A 29-year-old pregnant woman with suspicion of CT was referred to Al-Zahra teaching hospital due to
painful contractions. She had not received standard prenatal care, and the first assessment was performed at 28 weeks of
pregnancy. The results of abdominal examinations and Leopold maneuver showed that the fundal height (the distance from
pubic bone to the top of the uterus) was about 30 centimeters and the fetal heart rate was 140 beats per minute. Abdominal
ultrasound showed the two fetuses were conjoined from the face to the thoracic region. Due to the non-separable case, the
pregnancy was terminated by cesarean section (CS) under spinal anesthesia. The CT weighed 1120 g and measured 38 cm in
height and died after a while with no resuscitation effort.
Conclusions: This report emphasizes that a history of healthy pregnancies does not guarantee future uncomplicated
pregnancies. Therefore, it is crucial for healthcare policymakers to implement comprehensive strategies ensuring that all
pregnant women have access to necessary prenatal care, regardless of their financial situation or awareness of available
services
Introduction: This case report underscores the critical importance of early and accurate prenatal care in identifying serious
fetal anomalies, such as conjoined twins (CT), which can significantly impact maternal and fetal outcomes. The failure to
provide standard prenatal care not only led to a missed opportunity for early diagnosis but also resulted in a late-term cesarean
delivery that inflicted considerable psychological trauma on the mother.
Case Presentation: A 29-year-old pregnant woman with suspicion of CT was referred to Al-Zahra teaching hospital due to
painful contractions. She had not received standard prenatal care, and the first assessment was performed at 28 weeks of
pregnancy. The results of abdominal examinations and Leopold maneuver showed that the fundal height (the distance from
pubic bone to the top of the uterus) was about 30 centimeters and the fetal heart rate was 140 beats per minute. Abdominal
ultrasound showed the two fetuses were conjoined from the face to the thoracic region. Due to the non-separable case, the
pregnancy was terminated by cesarean section (CS) under spinal anesthesia. The CT weighed 1120 g and measured 38 cm in
height and died after a while with no resuscitation effort.
Conclusions: This report emphasizes that a history of healthy pregnancies does not guarantee future uncomplicated
pregnancies. Therefore, it is crucial for healthcare policymakers to implement comprehensive strategies ensuring that all
pregnant women have access to necessary prenatal care, regardless of their financial situation or awareness of available
services
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