[Local Medical]Embryo splits 12 days late

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Text: He Jianxing Organizer: Liang Yingxiu

Being able to give birth to twins or twins is the long-cherished wish of many parents. Little do they know that this is actually just a thin line away from Siamese twins, but the fate of the two is completely different. The former represents happiness, while the latter is more regarded as tragedy or misfortune.

(Kuala Lumpur News) With the development of medicine and the advancement of technology, twins, twins, and triplets have received many blessings. However, from a medical point of view, twins are not necessarily identical in appearance. Identical twins (monozygotic twins/identical twins) or fraternal twins (dizygotic twins/fraternal twins), in the natural probability, every 80 to 90 pregnant women will have a pair of twins, and it has also increased with the popularization of test-tube babies. Chances of twins.

Identical twins look genetically identical

Dr. Ng Kok Chong, a consultant in obstetrics and assisted pregnancy, pointed out that identical twins refer to a fertilized egg formed by one egg and one sperm, which splits into two or more during the process of fertilization and embryo formation. Embryos can be imagined as two babies sleeping on a bed, because they receive identical chromosomes and genetic material, so the appearance, sex and genes of identical twins are exactly the same, just like coming out of the same mold, the only one The difference is fingerprints and grown-up personality and preferences.

“Because they receive identical chromosomes and genetic material, identical twins have a special feature, that is, once they need to donate organs such as kidneys or livers to each other, there is no need for blood tests and matching, and there is no need to worry. Organs can be directly donated in the event of rejection, on the grounds that there is a certain fit between the recipient and the donor.”

He said that as for fraternal twins, two eggs and two sperm combine at the same time to form two different embryos, and finally two different babies. They have separate amniotic membranes and placenta, which can be imagined as the same twins. In the two houses under the eaves, fraternal twins can be male, female, or even a male and a female, which is commonly known as twins. Their personalities, genes, and appearances are different, because they are different from each other. The sperm and egg are combined, so the genetic inheritance is different.

Conjoined twins separated in Malaysia

It is worth noting that being pregnant with twins means that the pregnant woman has to bear double the burden. Therefore, special attention must be paid to nutritional intake, including iron and protein, and more importantly, to maintain a happy mood and pay attention to rest. The support of family members is very important , especially as a husband.

He said that, in fact, when we offer blessings to twins, we should not ignore the conjoined twins whose causes are almost similar to twins.

Last year, Tunku Azizah Hospital (HTA) just completed a pioneering work. The team led by Dr. Chakaria, Consultant Pediatric Surgeon, successfully gave birth to a 17-day-old conjoined twin after 10 hours and 7 packs of blood. The separation operation was performed, and then sent to the intensive care unit for observation and treatment. This separation operation of the smallest patient in the hospital’s history was also personally congratulated by the Minister of Health and the Director of Health.

“The biggest difference between conjoined twins and twins is the

It is the time point when the egg and sperm are combined to divide the embryo,

Generally, identical twins split into two different embryos on the first day after the sperm and egg unite.

However, the conjoined twins were 12 days late, that is, they split on the 13th day.

And in less than 2 weeks, the two were destined to have different fates.

If parents who gave birth to twins today feel honored and happy, then the parents who gave birth to conjoined twins are completely opposite, because the birth of conjoined twins is still regarded as a “freak” to this day, and the survival rate is extremely high. Low, and the fate is more rough (have had to undergo different operations since birth to survive). “

share the same organ

Only seen in identical twins

Siamese twins refer to two babies born at the same time in one birth, but the body organs of the two are not completely independent, such as sharing the same liver and heart.

This happens only with identical twins, not with fraternal twins.

According to ancient and modern Chinese and foreign historical records, the existence of conjoined twins was mentioned in the book “De Civitate Dei” (De Civitate Dei) in AD 415, and a pair of conjoined twins were brought to the Western leaders at that time as “freaks” exhibition , and in the Western Han Dynasty of China, conjoined twins were also recorded, but they were all regarded as freaks or ominous things. They were often treated by abnormal people, such as being exhibited as freaks or performing in circuses.

Can the existence of conjoined twins be detected early?

Caesarean section only, not natural delivery

Huang Guochong pointed out that in the past, when the detection equipment was not developed, it was difficult to find conjoined twins in the mother’s womb through consultation or observation. Usually, it was not known that conjoined twins were born until caesarean section. Not only the fetus had dystocia and death chances, but also pregnant women Precious lives were lost due to dystocia.

“However, with the invention of more and more advanced detection and scanning instruments, it is now possible to detect in time in the early stages of pregnancy. At this time, pregnant women can also choose whether to terminate this pregnancy. Usually, obstetricians and gynecologists will also advise Pregnant women choose to abort their pregnancies, citing the risks and low survival rates.”

According to research, the survival rate of conjoined twins is not high, especially when conjoined twins share the same organs such as liver and heart, their survival rate will be even lower. Even if conjoined twins have separate organs, separation surgery must be performed after birth The risk is particularly high, further reducing the survival rate, which is why doctors will advise pregnant women to terminate pregnancy once they are detected early during the birth checkup.

He emphasized that if the existence of conjoined twins is discovered too late, and the prenatal examination confirms that the fetus is viable, then the only way is to give birth to them before deciding how to proceed, including the separation operation after birth. As for the mode of delivery There is only one kind, that is to use caesarean section instead of natural delivery, the reason is that the vagina cannot allow two babies to be born at the same time.

Obstetric inspection found to advise termination of pregnancy

Is the success rate of the separation operation of conjoined twins high?

“In fact, it must be admitted that the survival rate of conjoined twins is very low. Most of them died during the embryonic period, and even after birth, the survival rate is not high. As for the separation operation, it is still a difficult large-scale operation in the medical field. , Cases of death after surgery abound.”

Another question that is often raised about conjoined twins is whether the separation operation has not been performed, and one of them dies, will the other still survive? In fact, the ending is not optimistic, because when one of them dies, the survival rate of the other will be low, and they may even die together. The reason is that they share most of their organs. In the event of a tragedy, doctors will advise pregnant women to terminate the pregnancy in time.

1 fetal death

Another baby survived

Question 1. If one of conjoined twins dies, the other will die soon. If this happens to identical or fraternal twins, is it the same?

Answer 1.The two are different. Since identical twins or fraternal twins are two different babies, it is not uncommon for obstetricians and gynecologists if one dies during pregnancy but the other survives, especially in At the beginning of pregnancy, before 12 weeks, it was found that there were originally two embryos during the scan through the obstetric examination.

But one of them died while growing up, so only one survived, thus becoming singles instead of twins.

Dead embryo poisoning of live fetuses in the second trimester

Q2. Will the dead embryo pose a danger to another living embryo?

Answer 2.No, the dead embryo will gradually shrink and disappear in the mother’s womb, so it will not affect the other surviving embryo.

However, it must be noted that if one of them dies during the second trimester (weeks 13 to 28), the chances of death will be higher, because the dead embryo will produce toxins that will affect the other embryo.

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