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Conjoined twins are identical twins [1] joined in utero . An extremely rare phenomenon, the occurrence is estimated to range from 1 in 49,000 births to 1 in 189,000 births, with a somewhat higher incidence in Southwest Asia and Africa. [2] Approximately half are stillborn , and an additional one-third die within 24 hours. Most live births are female, with a ratio of 3:1. [2] [3]