Conjoined twins of one or both of the twins, particularly if they are joined at the head or share a vital organ. This makes the ethics of surgical separation, where the twins can survive if not separated, contentious. Alice Dreger of Northwestern University found the quality of life of twins who remain conjoined to be higher than is commonly supposed. Lori and George Schappell and Abby and Brittany Hensel are notable examples. The first record of separating conjoined twins took place in the Byzantine Empire in the 900s. One of the conjoined twins had already died, so surgeons attempted to separate the
Monochorionic twins Monochorionic twins Monochorionic twins are monozygotic (identical) twins that share the same placenta. If the placenta is shared by more than two twins (see multiple birth), these are monochorionic multiples. Monochorionic twins occur in 0.3% of all pregnancies. 75% of monozygotic twin pregnancies are monochorionic; the remaining 25% are "dichorionic diamniotic". If the placenta divides, this takes place after the third day after fertilization. Monochorionic twins generally have two amniotic sacs (called Monochorionic-Diamniotic "MoDi"), but sometimes, in the case of monoamniotic twins (Monochorionic-Monoamniotic "MoMo"), they also share the same amniotic sac. Monoamniotic twins occur when the split takes place after