Various studies suggest that mechanical disturbances such as shaking of the blastomeres, exposure of the embryo to cold or insufficient oxygen during the early process of cleavage, grafting organizer onto gastrula or half a gastrula together, or constricting the blastula or early gastrula can cause the incomplete separation of monozygotic twins. However, studies have shown that these disturbances must happen at critical times in the pregnancy for the conjoined twins to develop. Complications
Conjoined twins are at high risk to being stillborn or dying shortly after birth. In some cases, a healthy twin and a parasitic twin are born. The parasitic twin has no hope for survival and dies and is then surgically separated from its twin. Depending upon how the twins are attached and what is shared among them, complications can arise from surgically separating the live twin from the dead twin. In Ischiopagus cases, the children share a pelvic region along with the gastrointestinal tract and genital region. Ischiopagus twins need reconstructive surgery for the genitals and gastrointestinal tract in order for normal bowel movements and reproductive possibilities in adulthood. For the Ischiopagus twins that both survive from birth, complications and risks also arise. Usually if both twins survive labor, one twin will be healthy and strong, while the other is malnourished and weak. Thus, surgery would have to be planned in advance to understand the best option and how to keep both children alive during surgery as well as afterwards. Treatment
Separation is the only treatment for Ischiopagus.
Often lifestyle modification is combined with medication therapy. For example, statins help to lower cholesterol. Antiplatelet medications like aspirin help to prevent clots, and a variety of antihypertensive medications are routinely used to control blood pressure. If the combined efforts of risk factor modification and medication therapy are not sufficient to control symptoms or fight imminent threats of ischemic events, a physician may resort to interventional or surgical procedures to correct the obstruction. Treatment
Treatment of established disease may include medications to lower cholesterol such as statins, blood pressure medication, or medications that decrease clotting, such as aspirin. A number of procedures may also be carried out such as percutaneous coronary intervention, coronary artery bypass graft, or carotid endarterectomy.Medical treatments often focus on alleviating symptoms. However measures which focus on decreasing underlying atherosclerosis—as opposed to simply treating symptoms—are more effective. Non-pharmaceutical means are usually the first method of treatment, such as stopping smoking and practicing regular exercise. If these methods do not work, medicines are usually the next step in treating cardiovascular diseases and, with improvements, have increasingly become the most effective method over the long term.The key to the more effective approaches is to combine multiple different treatment strategies. In addition, for those approaches, such as lipoprotein transport behaviors, which have been shown to produce the most success, adopting more aggressive combination treatment strategies taken on a daily basis and indefinitely has generally produced better results, both before and especially after people are symptomatic.