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<title>From 'Monsters' to Modern Medical Miracles - Embryology and Classification of Conjoined Twins</title>
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<li class="usa-breadcrumb__list-item"> <a href="/hmd/index.html" class="usa-breadcrumb__link"><span>History Home</span></a> </li><li class="usa-breadcrumb__list-item"> <a href="index.html" class="usa-breadcrumb__link"><span>From 'Monsters' to Modern Medical Miracles Home</span></a> </li><li class="usa-breadcrumb__list-item"> <span>Embryology and Classification of Conjoined Twins</span></li>
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<img src="images/conjoined.png" alt="Banner containing six icons that link to the individual pages of the website. From left to right: 1. Image of three embryos, that links to the Embryology page. 2. Image of conjoined twins from a 15th century book, that links to the Age of Superstition page. 3. Image of Millie-Christine McCoy, that links to the Marvels on Exhibit page. 4. Image of Clara and Alta Rodriguez, that links to the Separation Surgeries page. 5. Image of a fine engraving of two sets of conjoined twins, that links to the Gallery of Images page. 6. Image of a title page, that links to the bibliography page. Below the banner, to the left of the links to each page is a large eighteenth century woodcut illustration of female twins joined at the back." title="From 'Monsters' to Modern Medical Miracles: selected moments in the history of conjoined twins from medieval to modern times." usemap="#Map2" />
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<area shape="rect" coords="0,0,960,107" href="index.html" alt="From 'Monsters' to Modern Medical Miracles: selected moments in the history of conjoined twins from medieval to modern times." title="From 'Monsters' to Modern Medical Miracles: selected moments in the history of conjoined twins from medieval to modern times home" />
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<area shape="rect" coords="66,108,203,216" href="embryology.html" alt="Embryology and Classification of Conjoined Twins" title="Click here to go to the Embryology and Classification of Conjoined Twins page" />
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<area shape="rect" coords="349,108,483,216" href="marvels.html" alt="Marvels on Exhibit" title="Click here to go to the Marvels on Exhibit (19th Century) page" />
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<area shape="rect" coords="493,108,615,216" href="separation.html" alt="Separation Surgeries" title="Click here to go to the Separation Surgeries (20th Century) page" />
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<h2>Embryology of Conjoined Twins</h2>
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<p>
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Identical twins develop when a single fertilized egg, also known as a monozygote, splits during the first two weeks of conception. Conjoined twins form when this split occurs after the first two weeks of conception. The monozygote does not fully separate and eventually develops into a conjoined fetus that shares one placenta, one amniotic sac, and one chorionic sac. Because the twins develop from a single egg, they will also be the same sex. The extent of separation and the stage at which it occurs determine the type of conjoined twin, i.e., where and how the twins will be joined. </p>
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<div class="imgLeft">
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<a href="images/img_14B.jpg" target="_blank"><img src="images/img_14a.jpg" alt="Nineteenth century drawing of 5 embryos of conjoined twins showing the partially separated germ segments." title="Fig. 3847 from: Fisher, George Jackson. “Teratology,” A Reference Handbook of the Medical Sciences. New York: William Wood, 1889. , vol. 7, p. 14. Courtesy National Library of Medicine (NLM UI 31830700R)." /></a>
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</div>
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<p>The diagram at left illustrates the germ layers in embryos of conjoined twins. The proximity of the segments determines how much shared tissue there will be. The further apart the segments, the greater the likelihood that the organs will develop fully in each fetus. If the segments are at their farthest point, there will only be a minimum of tissue and cartilage joining the twins, i.e. omphalopagus twins will develop.</p>
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<h2>Classification of Conjoined Twins</h2>
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<p>
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Isidore Geoffroy Saint-Hillaire was the first teratologist to classify conjoined twins, using Greek etymology to describe the twins in terms of their shared anatomy. Many of his terms are still in use today. Listed below are some commonly occurring types of conjoined twins, examples of which may be viewed throughout this exhibit.
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</p>
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<div class="img100left"><a href="images/img_35B.jpg" target="_blank"><img src="images/img_35.jpg" alt="Nineteenth century drawing of twins joined at the crowns of their heads." title="Fig. 3862 Cephalopagus craniodidymus (Sannie) from: Fisher, George Jackson. “Teratology,” A Reference Handbook of the Medical Sciences. New York: William Wood, 1889. , vol. 7, p. 23. Courtesy National Library of Medicine (NLM UI 31830700R)." /></a>
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<div class="desc2"><p>Craniopagus: joined at the cranium (head).</p>
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</div></div>
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<div class="img100right"><a href="images/img_10B.jpg" target="_blank"><img src="images/img_10.jpg" alt="Nineteenth century drawing of adult male omphalopagus or xiphopagus twins. The twins share a band of tissue in the region of the umbilicus." title="Fig. 3869. Omphalopagus Ziphodidymus (Pancoast) from: Fisher, George Jackson. “Teratology,” A Reference Handbook of the Medical Sciences. New York: William Wood, 1889. , vol. 7, p. 25. Courtesy National Library of Medicine (NLM UI 31830700R)." /></a>
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<div class="desc2"><p>Omphalopagus or xiphopagus: joined in the region of the umbilicus.</p>
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</div></div>
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<div class="img100"><a href="images/img_1B.jpg" target="_blank"><img src="images/img_1.jpg" alt="Late fifteenth century woodcut illustration of female twins, joined at the chest." title="Monstrosa hois forma. Frontispiece from: Locher, Jacob, 1471-1528. Carmen heroicum de partu monstrifero. Ingolstadt: Johann Kachelofen, after 26 Nov. 1499. Courtesy National Library of Medicine (NLM UI 9413822)." /></a>
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<div class="desc2"><p>Thoracopagus: joined at the thoracic cavity (chest).</p>
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</div></div>
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||
<div class="img100left"><a href="images/sep_6B.jpg" target="_blank"><img src="images/sep_6.jpg" alt="Twentieth century photograph of newborn ischiopagus twin girls being held by a nurse. The twins are joined at the inferior margins of the coccyx and sacrum and have separate spinal columns." title="Photograph of newborn ischiopagus twins, Clara and Alta Rodriguez, 1973. Courtesy C. Everett Koop (NLM UI 100961905)." /></a>
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<div class="desc2"><p>Ischiopagus: joined at the inferior margins of the coccyx and sacrum, with two separate spinal columns.</p></div>
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</div>
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||
<div class="img100right"><a href="images/img_12B.jpg" target="_blank"><img src="images/img_12.jpg" alt="Nineteenth century drawing of adult female African-American pygopagus twins, joined at the lateral and posterior surfaces of the coccyx and sacrum." title="Fig. 3848 Pygopagus Symmetros (Pancoast) from: Fisher, George Jackson. “Teratology,” A Reference Handbook of the Medical Sciences. New York: William Wood, 1889. , vol. 7, p. 17. Courtesy National Library of Medicine (NLM UI 31830700R)." /></a>
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<div class="desc2"><p>Pygopagus: joined at the lateral and posterior surfaces of the coccyx and sacrum.</p></div>
|
||
</div>
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</div>
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<div class="clearfix"></div>
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<p class=”margin-top-5”><small>Last Reviewed: March 11, 2024</small></p>
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