A patient treated for infeility, was diagnosed with twin pregnancy at 6 weeks gestation. On her follow up USG at 12 weeks, there was a single developing live fetus. Fuher management is?
This is a case of vanishing twin. This may occur in upto 1 out of 8 twin pregnancies. When a twin dies in the first trimester it has no significant effect on the mother or the surviving fetus. The pregnancy should therefore be continued as a normal singleton pregnancy. In a slightly more advanced gestation, fetal death may also go unnoticed until delivery and may be compressed appreciably- fetus compressus , or may be flattened remarkably -fetus papyraceus.
Twin Pregnancy, Molar Pregnancy, Gestational Trophoblastic disease and contraception in special situations (Sour Grapes!)
Advice MTP as the second twin is at increased risk of aboing
Continue pregnancy like a normal singleton pregnancy
Watch for coagulation defect in mother
Chorionic villous sampling
Continue pregnancy like a normal singleton pregnancy