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Background: Craniopagus parasiticus is a rare medical case and it is unique unlike other cases reported from different literature.
The head of parasitic twins is protruding from the temporal area of cranium. Parasitic head had two deformed lower limbs; one was
too rudimentary attached to the mass; long bones of bilateral lower limbs and some pelvic bones. After dissection of the mass, the
intestine was seen but no chest organs and other abdominal organs. There was also rudimentary labium but no vaginal opening.
Case Presentation: A 38-year-old multigravida women from Amhara ethnicity referred from rural health center to referral hospital
due to prolonged second state of labor at 42+1 weeks. Upon arrival, she had contraction, term sized gravid uterus and fetal heart beat
was 112. On digital pelvic examination, the cervix was fully diluted, station of the head was high and the pulsating umbilical cord was
coming in front of the presenting part with ruptured membrane but yet in the vaginal canal. The team decided emergency cesarean
section and then a live female infant weighing 4200 g was delivered. The placenta was single and normal. The APGAR scores were
seven and nine at 1 and 5 minutes, respectively. The infant appeared to be grossly normal except the parasitic co-twin attached at the
cranium. The neonate was investigated with the available investigations (CBC, X-Ray and Doppler ultrasound) and pediatric side
consultation made. After a week of counseling and investigations, successful separation operation was done. During post-operative
time, the neonate was comfortably suckling on breasts and no neurological deficit. The details of the surgery, post-operative condition
and subsequent follow up will be discussed during the conference.
Conclusion: The possible etiologies of craniopagus parasiticus are still unknown due to a rarity of cases. Doctors, genetic scientists,
epidemiologists and researchers continue to investigate this case as the reasons that could give clue to birth defect and to provide
answer for better prognosis of cases and improve the life chances of the twins. This case will have some input in the effort to know the
etiology and pathogenesis of this new born.