The Mysterious Vanishing Twin Syndrome!

Vanishing twin syndrome sounds really strange, but it was formally recognized in the year 1945. This is a syndrome that occurs when one of a set of twins or multiple fetuses disappears in the uterus during pregnancy. This occurs
as a result of a miscarriage of one fetus, where the other fetus or fetuses are alive and healthy. The fetal tissue is absorbed by the other multiple fetuses or the other twin fetus, the mother, or the placenta: giving the appearance of a vanishing twin.

How is this Syndrome Diagnosed?

The diagnosis of the dead fetus from a multiple pregnancy is made through the examination of the placenta immediately after the delivery. Today, due to the availability of ultrasonography, the presence of multiple or twin fetuses can
be detected early in the pregnancy. A second ultrasound can reveal the vanishing of the other twin or the fetus. This syndrome is diagnosed after the use of ultrasonography. The frequency of this syndrome is seen in about 21-30% of
multi-fetal pregnancies.

Causes of this Syndrome

The exact cause of this syndrome is unknown. The abnormalities found in the vanishing twin appear to be present from early development and occur gradually. When the placenta or the fetal tissue are analyzed, it is found out that there
are chromosomal abnormalities. Another cause is improper cord implantation.

Effects of this Syndrome on the Surviving Twin and Mother

If it occurs in the first trimester, then the mother or the other fetus does not show any clinical symptoms. The prognosis of the other twin surviving is excellent. However, this depends on the factors that have contributed to the death of
the other fetus. If the other twin dies in the 2nd and 3rd trimester, then there are dangerous risks to the surviving twin. This can include increased chance of cerebral palsy.

When one of the fetuses dies after the embryonic period, i.e. after eight weeks, then the fluid in the twin’s tissues, the placental tissues, and the amniotic fluid gets reabsorbed. This results in the disappearance of the dead twin and this
does not cause any pressure to the surviving fetus. During delivery, the deceased fetus is identified as fetus papyraceous, i.e. flattened dead twin through loss of fluid and the soft tissue.

Signs of this Syndrome

This case is seen among women who are above the age of 30.Problems are seen usually in the first trimester. Some of the common signs are uterine cramps, pelvic pain, and bleeding.

Complications of this Syndrome

Following are some of the complications that women with this syndrome can experience:

  • Pre-term Delivery or Cerebral Palsy:

Early delivery is one complication that can result in development problems and cognitive deficits. The surviving twin can be at a greater risk of developing cerebral palsy.

  • Low Birth Weight:

Dr. Almog has reported that approximately 1/3rd of the pregnant mothers who were diagnosed with this syndrome gave birth to low birth weight infants.

Medical Care for Vanishing Syndrome

There is no special care required for the mother and the surviving twin. However, if the fetal death occurs in the second or third trimester, then the pregnancy is taken as a high risk. A pregnant woman with twins or multiple pregnancies
must seek immediate medical care if she is experiencing cramping, bleeding, and pelvic pain. The woman can choose for natural miscarriages or the doctor may opt for Dilation and Curettage i.e. D&C.

If you are among the pregnant mothers carrying multiples, be sure to take care of yourself and your unborn babies by eating a balanced diet, having a calm mind, exercising regularly, and following your doctor’s advice. Have a happy
and healthy pregnancy.

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