Hiyab and Wuhbto, sisters born conjoined at the head in Ethiopia, were separated during a 25-hour operation at SSM Health Cardinal Glennon Children’s Hospital in St. Louis in February, the St. Louis Post-Dispatch reported.
Why the procedure is unusually complex
The sisters had craniopagus, a rare condition in which twins are joined at corresponding areas of the skull while the face and the opening at the skull’s base are generally separate. A systematic review in the Journal of Surgery and Medicine says craniopagus twins account for about 6% of conjoined-twin cases and occur in approximately 0.6 per million births worldwide.
The review also found that surgeons generally favor multiple-stage procedures for total craniopagus separations because staging can reduce risks such as hemorrhage, ischemic brain injury and neurotoxicity. That broad medical finding does not establish which specific strategy Cardinal Glennon used. The St. Louis surgical team spent about a year and a half preparing for the sisters’ separation, the Post-Dispatch reported.
The operation and its reported significance
How Missouri tracks birth defects
According to the Missouri Department of Health and Senior Services, about 1 in 33 babies born in the United States has a birth defect. The department says its Environmental Public Health Tracking Program collects data from the Missouri Birth Defects Registry on serious birth defects that studies suggest could be related to the environment.
SSM officials told the Post-Dispatch that the operation was one of roughly 67 craniopagus separations performed worldwide and the first in the United States led by a woman. The hospital had previously treated conjoined twins, according to the report.
Recovery after separation
After the operation, the sisters were placed beside each other as separate children and later participated in a play-based learning program at Ranken Jordan Pediatric Bridge Hospital in Maryland Heights on Sept. 9, the Post-Dispatch reported. The program was intended to support their development as they learned to move and communicate independently.
