Conjoined twins in West Africa.

12 cases of conjoined twins from West Africa were reported between 1936 and 1978. Eight sets were liveborn and were surgically separated either in local hospitals or abroad. Four were stillborn. Two new cases of stillborn conjoined twins were recently delivered at this hospital. The most common type and the ones most likely to be born alive were the omphalopagi. Surgical separation was successful in 5 cases but the twins separated at Zaria died about a month later. Emergency operations were performed on the pygopagus and ischiopagus, and one member of the former but both of the latter died. The thoracopagus and dicephalus twins were stillborn. However, necropsy findings in one of the thoracopagi indicate that surgical separation would have been feasible had the twins been born alive. The internal mechanical factors causing cardiac defects in such twins may be relevant to the study of the pathogenesis of congenital cardiac malformations.