Missing twin syndrome: what is it?

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Missing Twin Syndrome is when one or more fetuses die and are absorbed by the mother’s body, often without her knowledge. It affects 20-30% of multiple pregnancies and can cause psychological problems in the surviving twin. The causes are unknown, but it is more common in women over 30 and those using reproductive techniques. Diagnosis is usually made during a routine ultrasound. Counseling is available for expectant parents affected by the condition.

Missing Twin Syndrome is a medical phenomenon that affects some mothers who carry multiple fetuses. For unknown reasons, one or more fetuses may die and be completely reabsorbed by the body, leaving minimal traces, most typically in the first trimester of pregnancy. While the media has drawn attention to missing twin syndrome, creating the illusion of a rising rate, doctors suspect that the condition has likely simply been unidentified historically, and that increased monitoring during pregnancy has contributed to an increase of diagnoses of the condition.

The causes of missing twin syndrome are not known. Sometimes, the condition can be the result of life-incompatible birth defects or lack of access to necessary nutrients. For whatever reason, when the fetus dies, it is absorbed into its remaining sibling or siblings and the mother’s body. Often, the mother may be totally unaware of the situation, although mild cramping and breakthrough bleeding may occur in some cases. In some rare cases, the dead fetus may be desiccated and compressed by its siblings, in which case it will be delivered in a flattened state, whatever stage of development it was at before death. This is known as a papyrus fetus.

An estimated 20-30% of multiple pregnancies are affected by missing twin syndrome, although other members of the medical community have much higher and lower estimates. This means that many singles actually started out as twins and lost their siblings before birth. In some cases, missing twin syndrome causes psychological problems in the surviving sibling, known as a twin with no twins. Twins without twins sometimes experience confusion, guilt, loss, or other emotions that suggest they’ve been affected by the loss of their siblings.

Women over 30 appear to be at the greatest risk of disappearing twin syndrome, as are women who use hormones and other techniques to aid reproduction. Commonly, vanishing twin syndrome goes unnoticed and causes no complications. When it is diagnosed, it is usually diagnosed as part of a routine follow-up ultrasound, in which a doctor notes that the two heartbeats since early pregnancy have reduced to one.

When missing twin syndrome is diagnosed, it can be traumatizing, but women shouldn’t blame themselves. Because the causes of the condition are so ambiguous, it is usually safe to say that nothing could have been done to prevent the loss of the fetus, and complications from this condition are rare. Some expectant parents choose to seek counseling to discuss fetal loss, and their doctors can usually provide referrals for counseling services.




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