Prenatal sonographic diagnosis of a twinning epigastric heteropagus

Epigastric heteropagus is a rare type of conjoined twinning which results f rom an ischemic atrophy of one fetus at an early stage of gestation. We pre sent what we believe to be the first case diagnosed antenatally at 22 weeks ' gestation. The pelvis and lower limbs of the ischemic fetus (the parasite ) were attached to the epigastrium of the well- developed fetus (the autosi te), which had a small omphalocele. Antenatal sonography provided an accura te diagnosis, enabling unnecessary abortion to be avoided.