Vanishing twin syndrome (VTS) is a miscarriage that causes a pregnancy involving twins to become a pregnancy involving one baby. It occurs when one of the embryos detected during an ultrasound stops developing. VTS can't be treated or prevented.
It's also called disappearing twin syndrome, and it happens when there's a loss of one baby in a multiple pregnancy. Usually it occurs early in pregnancy and involves the loss of one twin, while the other twin survives. The fetal tissue from the vanishing twin is usually absorbed by the mother and the surviving baby.
Sometimes a second or third trimester miscarriage of one twin can cause significant obstetric problems. Premature labour, infection, bleeding and an increased risk of birth complications can all occur with a late stage miscarriage of one twin.
Sometimes not all of the pregnancy comes away after a miscarriage. An incomplete miscarriage is when a miscarriage begins, but some pregnancy tissue stays in the womb.
If this event happens in the first trimester of the pregnancy, the surviving twin will most likely develop without further consequences. However, if the fetal death occurs after mid gestation (17 weeks' gestation) there is an associated increased risk of preterm labor, IUGR, preeclampsia, and perinatal mortality [5,8].
How will you know for sure if you miscarried one twin? If you don't have an early ultrasound, you may never know that you miscarried a twin, or you may find out on your first ultrasound that there is a second gestational sac that does not contain a living twin.
Mothers who experience vanishing twin syndrome often have no symptoms. You may have spotting and cramps, which are common in pregnancy, especially during the first trimester. If vanishing twin syndrome occurs in the first trimester, doctors rarely take any special steps.
Although uncommon, it is possible for a miscarriage to be misdiagnosed. This can occur if the conception date is actually earlier than predicted or if there are some difficulties with the ultrasound technology. It's normal to experience light bleeding in early pregnancy.
No treatment (expectant management)
If it is an incomplete miscarriage (where some but not all pregnancy tissue has passed) it will often happen within days, but for a missed miscarriage (where the fetus or embryo has stopped growing but no tissue has passed) it might take as long as three to four weeks.
Pregnancies with vanishing twins demonstrated a significantly lower mean 2-day percent increase in β-hCG level than singletons and twins (114.3% vs. 128.8% and 125.4%, respectively). Vanishing twins arresting at earlier developmental stages demonstrated significantly further reduced β-hCG level increases.
Some people in online forums discuss the link between hyperovulation after miscarriage and an increased chance of having twins or baby triplets, but so far, there isn't scientific research to support this.
Spotting in pregnancy is often identified when a woman notices spots of blood on her underwear or on tissue after wiping. You may also notice some pink, brown, red or dark red blood. Sometimes women may pass fresh red blood, or clots. Some women also notice some string like tissue coming from their vagina.
Can an embryo split after 6 weeks? What about having twins happen after your first-trimester scan? It's very unlikely, as most twin embryos split within the first 2 weeks of fertilization.
Blastocyst stage (days 4–8) division results in monochorionic-diamniotic twins. Division at the 8–12-day stage results in monochorionic-monoamniotic twins, and division after day 12 leads to conjoined twins [1, 2].
In some cases, surgery is used to remove any remaining pregnancy tissue. You may be advised to have immediate surgery if: you experience continuous heavy bleeding. there's evidence the pregnancy tissue has become infected.
There is a chance you may see your baby in the tissue that you pass, but often the baby is too small to recognise, or may not be found at all. It is normal to want to look at the remains, but you may decide you do not want to. There is no right or wrong thing to do. Some women miscarry while on the toilet.
There are three main treatments for early pregnancy loss.
The goal for all three is to remove any pregnancy tissue left in the uterus. There are two nonsurgical treatments: expectant management (letting the tissue pass on its own) and medication.
An incomplete miscarriage is when a miscarriage begins, but not all of the pregnancy come away. Find out about the signs of an incomplete miscarriage and how this type of miscarriage will be managed.
Tissue tests.
If you have passed tissue, it can be sent to a lab to confirm that a miscarriage has occurred — and that your symptoms aren't related to another cause.
The chance of a twin miscarriage that affects both babies is around 5 to 10 percent, says Robin Kalish, MD, FACOG, a specialist in high-risk pregnancies.
Since ultrasonography and transvaginal sonography in early pregnancy, vanishing twin syndrome is more frequently diagnosed. Vanishing twin syndrome is evaluated to happen in 36% of twin pregnancies and in half of the pregnancies that begins with at least three or more gestational sacs.
Miscarriage at 5 weeks may often go unnoticed or feel like a heavier period, including symptoms such as vaginal bleeding or discharge.