Ultrasound testing reveals that a woman is carrying conjoined twins. She says, "Why did this happen? I've been so careful to take good care of myself." How should the nurse respond?

Question

1. "There is nothing you could have done to prevent this."
2. "It probably happened before you even knew you were pregnant."
3. "There is no way to find out why it happened, but they can be separated after they are born."
4. "We know that exposure to cigarette smoke is the primary reason for conjoined twins."

Answer 1

1
Rationale 1: Conjoined twins result when the embryonic disc does not divide completely. This action is out of the mother's control.
Rationale 2: Although this statement is true, it implies that if the woman had known she was pregnant she could have changed a behavior to prevent the conjoining of the twins.
Rationale 3: Most conjoined twins cannot be separated, and in any case the nurse would not be able to make this prediction based on a simple ultrasound.
Rationale 4: Exposure to nicotine and other toxins in cigarette smoke has been linked to other problems, but not to conjoined twins.