Conjoined twins – popularly referred to as Siamese twins – are twins joined in utero.[a] It is a very rare phenomenon, estimated to occur in anywhere between one in 49,000 births to one in 189,000 births, with a somewhat higher incidence in Southwest Asia and Africa. Approximately half are stillborn, and an additional one-third die within 24 hours. Most live births are female, with a ratio of 3:1.
Two possible explanations of the cause of conjoined twins have been proposed. The one that is generally accepted is fission, in which the fertilized egg splits partially. The other explanation, no longer believed to be accurate, is fusion, in which the fertilized egg completely separates, but stem cells (that search for similar cells) find similar stem cells on the other twin and fuse the twins together. Conjoined twins share a single common chorion, placenta, and amniotic sac in utero, but so do some monozygotic but non-conjoined twins.
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