The Vanishing Twin: Pathologic Confirmation of an Ultrasonographic Phenomenon

-

Sulak, M.D., L., Dodson, M.D., M.

Although the phenomenon of the “vanishing twin” has been noted repeatedly through the use of ultrasound, no confirmatory histologic evidence has been presented previously. This has raised questions concerning the validity of the vanishing twin syndrome. A triplet intrauterine pregnancy was diagnosed ultrasonographically four weeks after in vitro fertilization, but only a single fetus and placenta were delivered at term. Careful examination of the placenta revealed at term. Careful examination of the placenta revealed histologic evidence of the vanished twin. This evidence consisted of a chorion-lined sac containing amorphous material, surrounded by degenerated chorionic villi juxtaposed against a normal amniochorionice membrane. (Obstet Gynecol 68:811, 1986)

Landy et al reviewed nine sonographic studies that documented a vanishing twin frequency of between 53 and 78% in multiple pregnancies diagnosed sonographically during the first trimester.

Presented here is pathologic evidence of a vanished twin, and criteria for the diagnosis of similar cases is suggested.

Levi reported that 71% of twin gestation diagnosed sonographically before the tenth week of were indeed singletons when delivered.

Robinson and Caines observed 30 women diagnosed sonographically as having twin gestation in the first trimester. Fourteen patients ultimately delivered twins, for a disappearance rate of 16 in 30 (53.3%).

Loss of one twin during early gestation has a much higher incidence (53-78%) than the reported abortion rate of 10-15% for a singleton pregnancy or, by comparison, an expected 20-30% chance of at least one or both twins being aborted, if such events were independent. This suggests that local influences or competition between twins may result in an exceptionally high vanished twin rate during early pregnancy. In triplets and quadruplets, the effect of early fetal competition between twins may be even more intense. In reporting 300 early pregnancies evaluated by means of ultrasound noted 21 twins, one triplet, and one quadruplet. Only three pairs of twins survived to term (85.6% loss of the second twin), whereas the triplet pregnancy evolved into a normal twin gestation, and the quadruplet pregnancy reported here also evolved into a singleton gestation, and the quadruplet pregnancy evolved into a singleton gestation. The triplet pregnancy reported here also evolved into a pregnancy diagnosed by means of ultrasound that evolved into a twin gestation. These very high resorption rates, which cannot be explained on the basis of the expected abortion rate, again suggest intense fetal competition for space, nutrition, or other factors during early gestation, with frequent loss or resorption of the other twin(s). Another explanation would be an exceptionally high incidence of genetically or embryologically abnormal embryos in multiple gestation, with loss of one twin during the early gestational period.

Popular posts from this blog

Am I a Survivor of a Vanished Twin?

-
Questions to Discover if You May be a Vanishing twin Survivor Vanishing Twin is a word that’s been used since 2003 to describe the fetus or embryo that was a twin, triplet or other multiple but died early in the pregnancy, leaving no detectable trace at birth or before. The remaining child born is called a Vanishing Twin survivor. This is also known as the vanishing twin phenomenon. There are millions Vanishing Twin survivors in the world today that share some common characteristics. Instructions Step1 See if you feel different from other people. Maybe you have a strange sensation that somehow you don’t really exist, you’re not really here or shouldn’t be here. Step2 Look back to see if you have suffered from depression most of your life, you’ve had long-term problems with food and eating and perhaps you’ve always feared abandonment and rejection. These are common, similar feelings of Vanishing Twin survivors. Step3 Understand that feelings of wanting...
Read more

Taking a Deeper Look at the Vanishing Twin Syndrome

-
By Teshna Beaulieu, DC |  Certified NET Practitioner 7 Maple Ave. Philmont, NY 12565 | 518-672-4019 |  teshnab@taconic.net Subject Covered by the Article: So many people have been affected by the loss of a Vanishing Twin. I have identified several categories describing the modus operandi of VTS survivors which can help someone clear all the ramifications caused by the trauma of losing a loved one so early in the human experience. Many times I have found that people have had the VTS come up in NET sessions relating to one or more of the aspects described below. However, I found that many aspects have3 not come up yet even though they may be affecting the person’s life. This is a way of exploring these aspects on purpose and clearing them independently of any other topic. Summary of the NET Procedure: This is a procedure containing many steps found useful to help a person feel better about themselves, freer to be who they are and have their needs met without fear of terrible consequences...
Read more