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Of the many wonders of nature, none is more phenomenal than the miracle of life. From conception to birth, the complex process of an embryo’s development is fantastic. First the ovum is fertilized and begins growth. As the cells continue to grow and split, the genetic information in the DNA provide a ‘roadmap’ for the evolution of the organism. If a single fertilized ovum splits, the DNA will be the same in both embryos. This will result in maternal, or identical, twins.
Rarely, though it does happen, the process will occur with ‘errors’. Meaning that the egg will begin to split, but will stop before the separation is complete. The fetus will continue to develop, yet both ‘halves’ will develop together, and remain conjoined. This occurs approximately once in ever 40,000 births and only one in every 200,000 are live births.
When these twins are born, they can be conjoined at any number of physical points. The type of classification given to them is named for the point at which they are connected. Here is a list of the scientific classifications of conjoined twins:
1)Craniophagus: joined at the cranium, or head.
2) Pygophagus: attached at the posterior, or bum. Usually twins born in this fashion are like to be successfully separated.
3)Thoracophagus: sharing the upper portion of the torso. When this occurs, usually there is one heart shared between the two; making it impossible to separate the children and save both.
4)Cephalopagus: joined by the upper portion of the of the torso, and involves the cranium as well, with a face on either side of the head.
5)Dicephalus: separate heads and necks, yet one body.
6)Ischiopagus: twins joined at the lower portion of the back. Twins joined in this manner are most likely to be successfully separated, for it is likely no major organs are shared.
7)Omphalagus: connected from the breastbone to the waist, this is one of the more common classifications of conjoined twins.
8)Parapagus: twins of this classification are joined at the side and can extend an unspecified length.
There are two other types of twins that have been classified, but they are far less common:
9)Parasitic Twins: conjoined twins, one significantly smaller, less formed, and dependent on the other.
10)Fetus in fetu: one twin is completely formed, yet the other is partially formed within the body of the other.
Few conjoined twins are separated safely, with both twins leading an average life span after the operation. In the instance of conjoined twins, where separation is possible, but one child is ‘sacrificed’, what is the ethical choice? This question has caused debate in the medical field. If it is acknowledged that both children are living entities, individual human beings with individually functioning brains, then treating them as anything less is inhumane. Each child’s life is equally important and should not be disregarded in considering separation. "It is unethical to treat children with unusual anatomies according to a different set of ethical guidelines than other children,†agrees Alice D. Dreger, a Michigan State University medical historian. Unless both children’s lives are threatened, because of the medical conditions in one sibling, and it is determined that the ‘healthier’ twin can live without the ‘weaker’, only in this situation can it be deemed an ethically sound decision to separate the two.
Babies born under such circumstances are not, however, doomed. A number of twins have led happy, successful lives conjoined. Of the more famous are Chang and Eng Bunker, for whom the term ‘Siamese Twins’ was coined. These two boys were born in Siam on 10 May, 1811; and were connected by a large ligament protruding from the area of their breastbones. Luckily, before the birth of the Eng twins, over 100 cases of conjoined twins were on record. This is all that saved them from the execution that was ordered by the ruling King of Siam at the time of their birth.
The Bunker Twins lived to the age of 62, and fathered 21 ‘normal’ children by the sisters that they married, Adelaide and Sallie Yates. They were businessmen who were quite successful, and known to be respected in their home of Wilkes County, North Carolina. It was determined after their death that the Chang and Eng could have been successfully separated. However, this was information that was only known post mortem, so we will never know if they would have chosen separation.
The fact is, that cases of conjoined twins occur every year. Technology allows most cases to be detected in prenatal examinations. Once detected, there are hospitals and doctors who specialize in such births, and can provide the proper information and care to the expecting parents and children. After the birth, there are organizations and support groups to prepare families for complications, and answer any questions that may occur. You can locate institutions and organizations of this nature by contacting your local children’s hospital, or speaking to a primary care physician.
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