Partial fetotomy-assisted vaginal deliveryof dicephalic derodymus thoracopagus monster fetus in a buffalo

Introduction

Fetal monsters are also referred to as developmental abnormalities or congenital anomalies. Most fetal anomalies arise during the early stages of cell differentiation, when the developing conceptus is influenced by genetic and maternal factors. Mild developmental abnormalities of the ovum, embryo or fetus can result in structural defects, leading to congenital monstrosities (Purohit et al., 2012) [1] . In bovines, fetal twin monstrosities account for approximately 2.2-10% of all fetal abnormalities (Ravikumar et al., 2012) [2] . Among the various types of conjoined twin monstrosities reported, thoracopagus (twins are joined at the thorax) accounts for nearly 40% (Thangadurai et al., 2015) [3] . It has been noticed that conjoined twins are monozygotic and develop from a single ovum (Bhoi, 2009) [4] and are of the same sex (Arthur et al., 2001) [5] . Fetotomy is a good alternative for relieving the fetal monster that causes dystocia (Vermunt, 2009) [6] . This case report describes the successful per-vaginal delivery of conjoined female monster fetus in a primiparous buffalo following partial fetotomy.

Case history and observation

A four-year-old primiparous Murrah buffalo was reported to the Teaching Veterinary Clinical Complex, DUVASU, Mathura (U.P.) with an anamnesis of full-term gestation, rupture of the water bags eight hours ago, mild staining and difficulty in parturition since last night. The case was initially attempted at field level by a local practitioner but was unsuccessful. On visual examination, it was found that animal had loosening of sacro-sciatic ligaments and two hind limbs along with tail were hanging out through the vulva (Figure -1). Clinical examination revealed the animal had all vital parameters within the normal range, including good body condition. Gynaeco-clinical examination revealed a dried, dilated birth canal, dilated cervix and three more limbs were palpated in the deep uterine cavity without any reflexes. The fetus was diagnosed as a monster fetus and it was decided to deliver this fetus per-vaginally by fetotomy without opting for caesarean section.

Treatment and Discussion

The buffalo was restrained properly in lateral recumbency followed by low epidural anaesthesia (2% lignocaine hydrochloride @ 5 mL) administration to avoid pain and straining. Birth passage was lubricated with ample amount of liquid paraffin and intravenous administration of inj. Dexamethasone @ 40 mg as antishock and inj. Tranexamic acid @ 5 mg/kg body wt. as hemostat. After failure of obstetrical manoeuvre, percutaneous detruncation, at the level of lower abdomen, was done with double-barrelled Thygesen's fetotome.

After detruncation space was formed, and three fore limbs were taken out at the vulval region and deviated head was felt in deep uterine area, but all the pelvic space was occupied by three forelimbs; then it was planned to cut one forelimb with the help of fetotome. After cutting the one forelimb as it creates space, deviated head was corrected and pulled out from vulva by fixing the William's long blunt hook in both inner canthus of eye orbit. Three point traction (two in both fore limbs with Moore's obstetrical chain and one deep throat region with hook) was applied which resulted in to successful per-vaginal delivery of the Dicephalic Derodymus Thoracopagus Tetrabrachius Tetrapus Dicaudatus dead monster (Figure -2) along with placenta. The monster fetus had two heads (Dicephalic), two necks (Derodymus), four forelimbs (Tetrabrachius), four hind limbs (Tetrapus), two separate tails (Dicaudatus) but jointed at thorax (Thoracopagus). Postoperatively, the animal was administered with inj. calcium borogluconate @ 450 mL, slow IV and inj. oxyotocin @ 50 IU, IM. The animal was also treated intramuscularly with inj. ceftriaxone @ 10 mg/kg body wt., inj. flunixin meglumine @ 2.2 mg/kg body wt., inj. chlorpheniramine maleate @ 0.5 mg/kg body wt. and intrauterine therapy was done with 4 boli of oxytetracycline (each 500 mg) and nitrofurazone (60 mg) & urea (6 gm). Owner was advised to give oral herbal ecbolic syrup @ 200 mL/ day and follow this treatment for 5 days. Further, postpartum findings of the monster fetus revealed one pair of lungs with a single heart, two pairs of kidney and a pair of spleen, liver with gallbladder and out of two uteri, one was unicornuate and another was bicornuate (Figure -3). The dam recovered clinically during the reported follow-up period.

Dystocia is a common sequel of thoracopagus monstrosity (Kumar et al., 2018) [7] . They are the result of incomplete division of a fertilized ovum and show great variation from partial duplication to almost complete separation of two individuals, joined in just a few places. Conjoined twin is resulted from incomplete subdivision of the embryonic axis that occurs at a relatively later phase of development (Kumar et al., 2012) [8] . Previously reported, Thoracopagus conjoined twins were female (Singh et al., 2025) [9] and male (Singh et al., 2020) [10] , indicating that conjoined twins usually possess the same sex, as observed in the present female fetus. Dicephalus Derodymus monsters (having 2 heads and 2 necks separately) have previously been reported in buffaloes (Dutt et al., 2018; Singh et al., 2018) [11,12] and cows (Ravikumar et al., 2022) [13] , where the fetuses were delivered per vaginally by fetotomy, similar to the present case. Caesarean section is not required in all cases, fetotomy is the best alternative method for delivering such cases which avoid the postoperative complications of caesarean section, such as uterine adhesions, peritonitis (Kumar et al., 2019) [14] and a low survival rate of 45.11% (Singh et al., 2013) [15] . In this case fetotomy was performed to deliver this monster fetus. On thorough post-mortem examination, it was found that fetus was having single heart and liver with a pair of spleens, two pairs of kidneys, one pair of lungs and out of two uterus, one was bicarnuate and the other was unicornuate. Uterus unicornis is a congenital anomaly that results from the developmental failure of paramesonephric/ Mullerian duct, reported in this case.

Conclusion

Timely assessment of the thoracopagus monster fetus can be delivered with the help of fetotomy, which is less time-consuming and require less preparation as compare to cesarean section and chances of postoperative complications like uterine adhesion and peritonitis are least. The future fertility of the animal is good if safely performed. In present case, longer reproductive follow-up is required to assess subsequent fertility

Acknowledgement

AcknowledgementAuthors are highly grateful to the Head of the Department to provide necessary facilities to carry out the work.

References

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16. How to cite this article: Singh AK, Basera A, Tiwari G, Pandey R, Kumar M, Sachan V. Partial fetotomy-assisted vaginal deliveryof dicephalic derodymus thoracopagus monster fetus in a buffalo. International Journal of Veterinary Sciences and Animal Husbandry. 2026;11(9):157-160. doi: https://www.doi.org/10.22 271/veterinary.2026.v11.i9c.3804