Abstract
Conjoined twin pregnancies are rare, and multidisciplinary approach in higher level of healthcare services are urgently needed. This paper aims to analyze the maternal referral system in the case of conjoined twin pregnancies in Dr. Soetomo Hospital to prevent delay of care for both mother and fetuses. This cross-sectional study analyzed medical records from maternity ward in Dr.Soetomo Hospital from 2010 to 2019. The records were compiled then grouped based on several criteria as follows: gestational age at the time of referral, mode of delivery, referral source and neonatal outcomes. Total referred cases of conjoined twin pregnancies are 16 cases with thoracoabdominophagus as the most common type of conjoined twins. 10 (63%) cases were delayed referral of ?21 WGA. C-section was performed in 9 (56%) cases of delayed referral, and the remaining 6 (44%) cases by vaginal delivery. Neonatal outcomes are generally worse, 9(55%) twins promptly deceased after delivered, 2 (13%) and 3 (19%) twins were deceased after 1 hour and 24 hours post partum respectively. Only 2 twins survived perinatal period but deceased 2 days later. Early diagnosis and referral are mandatory for suspected conjoined twin pregnancies to reduce maternal and neonatal morbidities and mortalities. Congenital anomalies screening by ultrasound are highly encouraged in 11-13 WGA or at first trimester for early diagnosis.
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