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Conjoined twins have an estimated prevalence between one in 50,000 and one in 1,00,000 births. Prenatal two- and threedimensional (2D and 3D) real-time ultrasonography is the most reliable method for establishing a prenatal diagnosis and detecting associated anomalies. Recent improvements in ultrasonography have made early diagnosis of conjoined fetuses in the first trimester possible. Most cases of conjoined twins occur in monochorionic monoamniotic pregnancies, making sonographic identification of distinct placentae and/or intervening amniotic membrane(s) a criterion to exclude fetal conjunction. There are two opposing pathogenetic theories, supporting fission vs fusion of embryos in the early first trimester. In very rare cases of diamniotic monochorionic conjoined twins, a distinct pathogenetic mechanism of conjoined twinning, similar to that of body stalk anomaly may exist. Prenatal diagnosis of conjoined fetuses is essential for further management. Parents need detailed counseling in order to decide among various management options--(1) pregnancy continuation and scheduled neonatal surgery, (2) termination of pregnancy, and (3) multifetal pregnancy reduction or selective fetocide in cases of high-order multifetal pregnancies with a component of conjoined fetuses. Pre- and postnatal management is challenging, and an interdisciplinary medical team involving obstetricians, neonatologists, pediatric surgeons, and anesthetists should carefully approach and assist parents in their decisions. In special cases, additional consultation by specialized centers in other countries may be needed. Furthermore, adequate psychosocial support should be offered, and palliative care services should be available in selected cases. [ABSTRACT FROM AUTHOR]

Rhabdomyoma is the most common fetal cardiac tumor accounting for 60-65% of all fetal tumors and up to 90% of cardiac tumors in pediatric population. Rhabdomyomas are benign lesions and the symptoms depend on the size and location of the rhabdomyomas. A single or multiple lesions are usually located within the left ventricle and projecting into the ventricular cavity or moving freely as a pedunculated mass. Intracavitary growth may cause ventricular outflow tract obstruction, valvular compromise, and disruption of intracardiac blood flows, leading to congestive heart failure. Rhabdomyomas >30 mm in diameter, regardless of number and location, are associated with postnatal arrhythmia. Cardiac rhabdomyoma is associated with tuberous sclerosis in about 50-90% of cases. Rhabdomyomas can be detected as early as the second trimester by echocardiography which is the primary diagnostic tool for the evaluation of cardiac tumors. They usually grow until 32 weeks gestation due to the transmission of maternal estrogens to the fetus, and then gradually regress. When cardiac rhabdomyoma is suspected on fetal echocardiography, it is important to check the kidneys and brain for tuberous sclerosis complex (TSC)-specific lesions. The prognosis depends on the number, size, and location of the tumors, as well as the presence or absence of associated anomalies. Rhabdomyomas, single or multiple, in the majority of cases, are not hemodynamically relevant and regress in infancy. Expectant management is the recommended approach, and neonatal management is always preferred when lung maturity is assured. Prenatal therapy is recommended only in case of severe fetal hemodynamic deterioration, hydrops, or uncontrollable arrhythmias. [ABSTRACT FROM AUTHOR]