Selective fetal reduction of conjoined twins in twin pregnan
The present case has been published in the Journal of South Asian Federation of Obstetrics and Gynaecology.

A 35 years old patient with history of infertility for 17 years conceived after In vitro fertilization–embryo transfer with donor oocytes due to ovarian factor; three embryos were transferred. Transvaginal sonography was done on 21st day after transfer and it revealed three gestational sacs with fetal pole in all the sacs.

Repeat TVS done on 65th day post embryo transfer revealed one gestational sac with single live embryo, second sac with two embryos joined at thorax and abdomen with a common heart, and two heads.

The couple was then counseled for fetal reduction in view of expected poor outcome of conjoined twins. Selective fetal reduction was done at 12 weeks gestation with intra-cardiac potassium chloride administration. Pregnancy is now ongoing with an apparently normal live singleton fetus.

Learning Points:-
• When conjoined twins are detected early, fetal reduction is a good modality of management.

• These pregnancies are associated with severe complications, maternal and fetal morbidity and mortality.

• Hence, the sooner the fetal reduction is, the better the management of conjoined twins.

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