Vanishing Twin Syndrome (Twin Embolisation Syndrome)

August 16, 2010

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Vanishing twin syndrome, also known as twin embolisation syndrome, is a condition in which one or more of a set of multiple fetuses disappears from the uterus during pregnancy.

With the use of ultrasound in early pregnancy becoming commonplace, there is an increasing awareness about vanishing twin syndrome. Early detection of twin and multiple pregnancies has made this phenomenon increasingly noticeable.

It is estimated that as many as 1 in 8 pregnancies begin as twin pregnancies. The presence of twins is not always diagnosed. Because in some cases vanishing twins disappear without a trace, it is difficult to say exactly how often the condition occurs, but it is thought that as many half of all pregnancies that begin as twin pregnancies may result in a single full term baby.

Vanishing twin syndrome, or twin embolisation syndrome, was first discovered in 1945.

The use of IVF and other assisted reproductive technologies (ART) frequently result in vanishing twin syndrome.

How is a Vanishing Twin Diagnosed?

Typically, an ultrasound is performed early in the first trimester (at about 6-8 weeks of gestation) which identifies more than one fetus. When the mother returns for future prenatal exams, only one heartbeat is detected and another ultrasound is done, which confirms there is only a singleton pregnancy.

What Happens When a Twin Vanishes?

In the case of a disappearing twin, the second fetus dies and aborts spontaneously. The fetal tissue gets reabsorbed by the mother, the placenta, or the other twin, and seemingly vanishes.

In some instances, rather than being completely reabsorbed, the aborted fetus will remain and become flattened by the remaining fetus. This results in a condition called fetus papyraceus.

A vanished twin is often the result of a chromosomal abnormality, placental abnormality, or blighted ovum.

What are the Signs and Symptoms of Vanishing Twin Syndrome?

Vanishing twin syndrome may bring with it no symptoms at all. Sometimes there is mild cramping, bleeding and pelvic discomfort. Symptoms may be similar to a miscarriage. It is sometimes possible to detect decreasing hormone levels indicating that one fetus has been reabsorbed.

Are There Any Complications that Result from a Vanishing Twin?

If the vanished twin occurs early in the first trimester of pregnancy, which is most frequently the case, and becomes reabsorbed, there are generally few or no complications which result.

If the vanished twin occurs late in the first trimester, or in the second and third trimesters, complications may include premature labor, infection, hemorrhage, and obstruction of the cervix.

In the condition of a vanished twin, there may be an increased likelihood of cerebral palsy in the remaining twin, particularly if the event occurs in the second trimester.

If a fetus papyraceus remains, it is possible that it can block the cervix.

Emotional Effects of Vanishing Twin Syndrome

If you have been diagnosed as having a vanishing twin, you may be experiencing a variety of emotions. You might feel grief, frustration, or guilt.

Some women feel that they may have done something to cause the condition. Vanishing twin syndrome has not been linked to anything in the mother’s control. It seems to be a spontaneous occurrence, most often due to a chromosomal or placental abnormality.

In most cases, the mother will be able to enjoy a full term healthy pregnancy with the remaining single baby.

Take the time to grieve your loss if necessary, and seek the help of a friend, therapist, or other healthcare provider when needed.

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