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The Vanishing Twin

Published online by Cambridge University Press:  01 August 2014

Helain J. Landy ,
Louis Keith  and
Donald Keith
Helain J. Landy
Affiliation:
Department of Obstetrics and Gynecology, Northwestern University Medical School, Prentice Women's Hospital and Maternity Center, Chicago
Louis Keith*
Affiliation:
Department of Obstetrics and Gynecology, Northwestern University Medical School, Prentice Women's Hospital and Maternity Center, Chicago Center for the Study of Multiple Birth, Chicago
Donald Keith
Affiliation:
Center for the Study of Multiple Birth, Chicago
*
333 East Superior Street, Suite 463–5, Chicago, Illinois 60611

Abstract

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In general, it has not been recognized that many twin or multiple gestations are lost in utero early in pregnancy. Until the advent of ultrasound, the ability to document early human fetal loss in multiple gestation was difficult. However, recent reports of serial ultrasound examinations of pregnant women have documented the “disappearance” of at least one of two gestational rings. Furthermore, the number of twins observed at delivery was significantly less than the number of twin conceptions originally identified by ultrasound during the first trimester. These observations led to the concept of the “vanishing twin” [8,10,13,15,17,20,22,35,41].

In order to obtain reference and personal data on this subject, we reviewed the literature and corresponded with members of the International Society for Twin Studies and obstetricians affiliated with Northwestern University Medical School, Chicago, Illinois. The nine studies that have documented this phenomenon cite “disappearance” rates ranging from 0% to 78%, depending on patient population and timing of ultrasonography [8,10,13,15,17,20,22,35,41]. Several explanations are offered: physiological mechanisms of “disappearance” (resorption or formation of a blighted ovum or fetus papyraceus), artifactual error, incomplete scanning technique, and poor quality ultrasound equipment. The only complication thus far associated with “disappearance” of a fetus is slight vaginal bleeding.

Keywords

Multiple gestationTwinsFirst trimester ultrasonography“Vanishing twin(s)”Blighted ovumResorptionFetus papyraceusFirst trimester bleeding
Type
Research Article
Information
Acta geneticae medicae et gemellologiae: twin research , Volume 31 , Issue 3-4: Special Issue on Twin Pregnancies , July 1982 , pp. 179 - 194
Copyright
Copyright © The International Society for Twin Studies 1982

References

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