Being pregnant is one of the toughest yet emotionally enjoyable tasks that are undertaken by the human body for 9 long months. Bringing a baby into this world is a joy beyond words and if you are blessed with twins, your joy only multiplies. However, as each pregnancy takes its own course, carrying twins is not as simple as a single-foetus pregnancy. The journey of twin pregnancy is tougher. A woman pregnant with twins worries about the health of both the twins and one factor that can be a cause of great worry is the vanishing twin syndrome. This is a syndrome wherein you miscarry one of the twins. A reason to be utterly disappointed when you have wanted your twins to be healthy, your prime worry when you miscarry one twin is whether you would be able to carry the other twin successfully till the end of the pregnancy term.
- Vanishing Twin Syndrome
- Occurrence Of Vanishing Twin Syndrome
- Signs And Symptoms
- Precautions Required For The Baby That Survives
- Potential Risk Factors Of Being Pregnant With Twins
Vanishing Twin Syndrome
When the miscarriage of one twin occurs, the fetal tissue is absorbed by the other twin. This gives the appearance of a vanishing twin. Determining the presence of twins is simple with the ultrasound scan that takes place during the first trimester. However, there are chances that your follow-up ultrasound scan could indicate the disappearance of one twin. Research has indicated that this syndrome occurs in about 21 to 30 per cent of multifetal pregnancies.
Occurrence Of Vanishing Twin Syndrome
This syndrome mostly occurs during the first trimester. What usually happens is that the pregnant woman is told that she is carrying twins after the first ultrasound that usually occurs during the sixth or seventh week of pregnancy, but a follow-up scan or a Doppler examination could indicate only one heartbeat, meaning that the other twin did not survive.
Early confirmation of multiple pregnancies is achieved when two or more embryonic sacs are observed during the scan. However, subsequent scans, after the initial one, could show only one viable sac. Thus, establishing the occurrence of the vanishing twin syndrome.
Signs And Symptoms
Although the exact cause of the vanishing twin syndrome is still unknown, the following are some of the signs and symptoms to look out for when carrying twins, which could hint at the occurrence of this syndrome.
• Bleeding: One of the earliest signs of miscarrying one of the twins is bleeding. When a woman miscarries, she bleeds continuously for a few days. You could also notice the loss of tissue.
• Cramps: An excessive amount of uterine cramping could indicate a miscarriage. The cramps would resemble that of severe menstrual pain. The uterine cramping might be accompanied by vomiting and nausea.
• Pain in the pelvic region: This is one of the biggest signs of vanishing twin syndrome. A dull, throbbing pain around your lower back or pelvic region could signal a miscarriage.
• Compression in the baby bump: If a compression in the baby bump is visibly noticeable, it could mean a miscarriage of one of the twins.
Precautions Required For The Baby That Survives
The likely reason for the loss of one baby and continuing to have the other is an abnormality of the placenta or umbilical cord or a disorder in the growing fetus.
You might not have clinical signs if you lose one of the twins during the first trimester. The prognosis of the twin that survived the miscarriage during the first trimester is usually good. However, it is dependent on a few factors that could have contributed to the death of the other twin.
If one of the twins dies during the second or the third trimester, then there could be health complications in the surviving fetus. The chances of the surviving twin having cerebral palsy are high.
When one of the twins dies after the embryonic period of the pregnancy, the water that had been within the twin's tissues, the placental tissue and the amniotic fluid get reabsorbed. This can cause the flattening of the deceased twin due to the pressure of the twin that survived.
During delivery, the fetus that died is identified as fetus compressus (that is compressed enough to be noticed) or as fetus papyraceous (that is flattened due to the loss of fluid and a major part of the soft tissue).
If the fetal death occurs during the second or third trimester, then the pregnancy is treated as high-risk.
Miscarriage is one of the worst fears of an expectant mother, but when you lose one of the twins, you should take utmost care of your health so that the other twin progresses well health wise and reaches the end of the term in a healthy and safe manner.
To continue to keep the surviving twin safe, you might be asked to be on complete bed rest till the end of your pregnancy.
Potential Risk Factors Of Being Pregnant With Twins
High-risk pregnancies are those that require close monitoring and quite a few precautionary measures. However, if you have been told that you are carrying twins and which makes your pregnancy high-risk, do not stress. With the guidance of your practitioner and a tension-free lifestyle, you can surely proceed smoothly in your pregnancy. Nevertheless, there are certain potential risk factors when pregnant with twins and it is good to be aware of them.
• Pre-mature birth: The chances of premature birth are high when carrying twins. You might have more rounds of antenatal appointments so that your pregnancy can be closely and frequently monitored.
• Miscarriage: Early miscarriage, during the first trimester, is common when pregnant with twins. Some might even happen before you would have noticed that you are pregnant.
• Gestational hypertension: With twins, you are likely to have pregnancy-induced high blood pressure.
• Pre-eclampsia: This is a health issue related to high blood pressure that occurs in later pregnancy. You would need to undergo a urine test at every antenatal appointment along with regular monitoring of your blood pressure. Protein in the urine along with high blood pressure signals pre-eclampsia.
• Anaemia: The amount of blood flowing in the system expands during pregnancy, especially when pregnant with twins. The blood also becomes diluted making you anaemic.
• Obstetric cholestasis: This happens due to the increased levels of oestrogen and progesterone. This ailment affects the liver.