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.
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
Twin Pregnancy, Molar Pregnancy, Gestational Trophoblastic disease and contraception in special situations (Sour Grapes!)