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Vanishing Twin Syndrome: Causes, Symptoms & Treatment
Twin pregnancies, although exciting, are often associated with pregnancy and delivery-related complications. Vanishing twin syndrome is one such complication which involves the loss of one of the multiple gestation.
What is Vanishing Twin Syndrome?
This is described as a condition seen in a multiple pregnancy in which one (or more than one in a triplet or quadruplet pregnancy) foetus happens to disappear intra-uterine before birth. It is assumed that the wasted foetal tissues are taken up either by the placenta or the other twin for nutrition.
How Common is Vanishing Twin Syndrome?
As per reports, multiple gestation occurs at a frequency of 3 to 5 per 100 pregnancies. The statistics of vanishing twin syndrome suggest that about 20-25% of these multiple pregnancies witness the phenomenon of vanishing twin syndrome. The data related to pregnancies and childbirth from European countries suggests that among every 100 babies born with assisted reported techniques (ART), around 15-20 are twin gestations.
Occurring early in the first trimester, this syndrome rarely causes any complication in the mother besides subtle abdominal cramping/pain and PV bleeds (vaginal bleeding).
Vanishing twin syndrome occurring in later pregnancy may cause complications like premature delivery, sepsis due to the retained products of conception, excessive bleeding, coagulopathies (inability of the blood to clot), and an increased risk of disseminated intravascular coagulation (creation of blood clots in the small blood cells). The foetal remnants, if low-lying in the uterine outlet, may cause an obstructed labour and might require assisted surgical delivery or caesarian section.
Besides mortality of the vanishing twin, it may also affect the well-being of the other twin by causing neurological problems like cerebral palsy or skin problems, like aplasia cutis (absence of skin).
Who is At The Risk of Getting Vanishing Twin Syndrome?
Studies suggest that maternal age is associated with vanishing twin syndrome. Increased maternal age (more than 30-35 years) often requires assisted reproductive techniques (ART) which in turn increases the probability of multiple gestations. Vanishing twin syndrome, as already described, occurs in multiple pregnancies with a frequency of 20-25 percent.
Causes of Vanishing Twin Syndrome
Why does the vanishing twin syndrome happen? The exact causes of vanishing twin syndrome largely remain undescribed. Placental tissues after birth of the healthy twin have been studied in detail. It is observed that the main reasons for the demise of one of the twins are developmental malformations and chromosomal anomalies, both largely genetic in nature. The other twin is usually healthy and unaffected. Placental conditions, in some cases, may also be the cause of foetal demise.
Signs and Symptoms
Vanishing twin syndrome in early pregnancy may be totally asymptomatic for the mother. In later pregnancy, it may cause symptoms similar to those of miscarriages. These include symptoms like:
Abdominal cramps
Bleeding through the vagina
Dull pain in the pelvic region
Routine blood tests may show a reduced level of Beta-HCG or the pregnancy hormone. It is secreted by the placenta and is usually tested to exclude conditions like vesicular mole.
These symptoms are non-specific and may only suggest a possibility of vanishing twin syndrome. You must consult your clinician if you experience any of these symptoms.
How Frequently Does the Vanishing Twin Syndrome Happen?
Vanishing twin syndrome is associated with multiple pregnancies which are quite common nowadays owing to the availability of assisted reproductive techniques. As discussed, it is estimated to occur at a rate of 20-30 per 100 multiple pregnancy cases.
Risks and Effects on Mother and Surviving Twin
The complications of vanishing twin syndrome are rare for the mother and the surviving twin if it occurs early (during the first trimester of pregnancy). However, the cause of foetal mortality may have an impact on the pregnancy outcome.
If it occurs during the second or third trimester, the other foetus is at a higher risk of having developmental problems including cerebral palsy.
Death of a twin during the embryonic phase may significantly reduce the amniotic fluid and cause the placenta to shrink in size. The living twin exerts pressure which causes structural changes in the dead foetal tissue. During delivery, the dead foetus may appear significantly compressed. This is known as foetus compressus. It could also be notably flattened due to the reduced amniotic fluid and placental shrinkage. This is known as foetus papyraceous.
Diagnosis
A diagnosis of vanishing twin syndrome is often made before it gets clear that the mother was actually carrying twins. An ultrasound examination confirms the diagnosis of a vanishing twin. It shows the presence of an embryonic sac with incompletely developed foetal parts, or by the absence of foetal cardiac motion in one of the two foetal masses (vanishing twin syndrome ultrasound diagnosis). When multiple gestation is confirmed, a blood test for beta HCG may also help diagnose vanishing twin syndrome. However, vanishing twin radiology is the only confirmatory and preferred investigation for diagnosis.
Treatment
No specific treatment is required for vanishing twin syndrome detected in early trimester of pregnancy, as long as the mother and living twin have stable blood flow. However, regular monitoring of the surviving foetus is advisable. If the surviving twin is healthy and scans show no abnormalities, there are good chances of a normal, uneventful pregnancy with the delivery of a single, healthy baby.
In cases diagnosed later (in second or third trimesters), the plan of treatment is largely based on the duration of pregnancy, developmental profile, and chorionic pattern of the living foetus. The twins could have either been monochorionic (shared chorionic and amniotic sac) or dichorionic (separate chorionic and amniotic sacs). Dichorionic twin gestations with either twin vanishing are generally safe for the other and require no intervention. However, the death of a monochorionic twin is an indication of urgent delivery of the other twin, provided it has attained lung maturity or crossed 32 weeks of gestation. The benefits of delivering the living baby should outweigh the risks of perinatal complications. In cases where delivery is not possible or advisable, the living foetus should be closely monitored for any intra uterine complications.
A recent advancement in the medical care for vanishing twin syndrome is cord occlusion for selective termination of the weaker twin. In the case of a monochorionic twin pregnancy with an impending vanishing twin, the umbilical cord of the affected twin is surgically closed off. This deprives the nutrition and circulation and completely cuts off the weaker twin from the placental circuit but on the other hand, safeguards the other twin from an interruption in blood supply or metabolic complications.
What Happens to the Other Baby?
A vanishing twin detected early in the pregnancy rarely affects the other twin. However, if it is detected in later pregnancy, the surviving foetus has a higher risk of intrauterine growth restriction. Preterm labour might be a risk for the mother, besides abnormal bleeding and maternal infections. A few studies on vanishing twin syndrome have reported that the surviving twin might also have a higher risk of cerebral palsy after birth.
How to Prevent Vanishing Twin Syndrome
Since the main cause of the syndrome is genetic or chromosomal anomalies, there is no specific prevention for vanishing twin syndrome. Chromosomal studies and genetic workup may be advised in cases with recurrence or similar family history. Repeated, unexplained miscarriages may indicate a need for genetic counselling for the couple.
Vanishing twin syndrome is an unfortunate and unavoidable complication of multiple pregnancies. Timely diagnosis and appropriate medical care can ensure safety and well-being of the mother and the surviving twin.
Also read: Twin Pregnancy Symptoms and Early Signs
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YouTube Kids App Launched by Google: Cool or Not?
Technology is growing smarter and so are your kids! To help your child’s technological development and to enhance his knowledge, Google has recently come up with a YouTube kids application. The app is available on Android and iOS based devices and is loaded with a lot of interesting and informative content.
Do you have a hard time getting fun apps to keep your kids engaged while making sure that they learn new things too? Then you must try the YouTube kids app recently launched by Google. The app is aimed at helping your child learn and explore new things at the same time. Since the App has exclusively been designed for kids, it also allows you to keep a check on their viewing habits. Take a look at the App's features listed below for your reference.
Features the YouTube Kids App has to Offer
It gives access to child-friendly videos, educational stuff, and songs.
It features content from National Geographic, DreamWorks TV, Jim Henson TV, and other child friendly YouTubers.
The home screen of the app has four icons including two light bulbs, one for educational programmes and another for popular videos, one radio icon for pop numbers, and a TV set for famous kids' television shows. These have been categorised as Learning, Explore, Radio, and Shows.
The YouTube kids application includes a timer that allowsyou to restrict screen time for your child. Once the app shuts down it can only be re-started when you key in the password.
It includes an option to limit the search settings so your kids can only view the videos you set on the home screen.
It gives you the option to turn off the sound effects and background music.
As a mother you would want your kids to explore new games and apps to figure out their area of interest. However, you might hesitate in leaving them unattended as the internet can offer a lot of content that is not suitable for children. This kids app is thus a brilliant option for parents as it only contains content which is appropriate for children and further allows you to limit the stuff you want your kids to watch. A pop-up box stating, ‘Try something else’ appears as soon as your child tries to access videos that have been restricted by you. This is the first ever app by Google which has been designed solely keeping kids in mind and thereby addresses parents' concerns tactfully.
The YouTube kids app has a user-friendly interface with large icons and tap targets, so that kids can browse smoothly. It also comes with a voice search feature made especially for the smartphone-friendly kids of this generation. This is one of the coolest apps for kids since parental control is easy and you can make sure your kids see stuff that makes learning fun - no wonder, its gained immense popularity in no time! Time for you to give it a try! Read more
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Rashes! A Big Concern. Say No to Rashes Forever and Be a Super Mom.
The first concern of any new mother is how to protect their newborn from diaper rashes(quite obvious as a new mother you want your baby to be happy always).
In this concern new mother end up using cloth nappies for babies which is also a good option but nowadays diapers are also considered equally good.
Indeed it is a topic of concern and is extremely painful for the newborn who gets rashes frequently.
But some of the tips mentioned below can help one to get rid of rashes forever.
Use good quality diaper and the one which is fitting and suiting the baby well (don’t buy local brands or non trusted brands as it can contain harmful chemicals and can hurt baby’s cute little bums)
Change the diaper immediately if you sense it’s soiled or urinated (don’t wait for hours to change the diaper.At night you can avoid changing the diaper until it’s soiled)
Now while changing the diaper make sure you clean the area well with baby wipes or with warm water using cotton.
Now allow the area to dry completely. This you can check using an organic tissue paper as well (I personally do this for my baby).
Once the area dries completely apply virgin coconut oil ( better than rash creams) on the sides and area where baby gets rashes often.
Make sure you apply with oil or cream with clean and washed hands or use cotton balls for the same.
Now place the new diaper and check if the sides are bit loose and baby is comfortable.
Note: To avoid rashes first try to purchases all the different brands of diaper available in the market and a size bigger. Check which one is suiting the baby best and keep using the same brand so that baby is comfortable and happy wearing them.
Believe it or not, the above-mentioned steps will not only heal the rashes but also will say goodbye to rashes forever.
Disclaimer: The views, opinions and positions (including content in any form) expressed within this post are those of the author alone. The accuracy, completeness and validity of any statements made within this article are not guaranteed. We accept no liability for any errors, omissions or representations. The responsibility for intellectual property rights of this content rests with the author and any liability with regards to infringement of intellectual property rights remains with him/her. Read more
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Pandemic Musing - Some teachings what coronavirus has done to the humans.
Some thoughts have been pondering over my mind past few days. Finally I got a chance to pick a pen to scribble those broken sequence of mental statements which I want to integrate and see if they really make some sense to the world.
The journey of coronavirus from epidemic to pandemic is not as short as the temper of some people. If I look at the people around me (ofcourse through social media), they are the insane ones who have already lost the battle - the battle against mankind.
The entire world is fighting this virus but the so called ‘Unity in Diversity’ personified Indians are busy fighting among themselves. Its perfectly alright to have an opinion (thats the beauty of living in a democratic country with access to social
media that you can easily ooze out what you feel and let others know your viewpoint). But forcing others to view your damn opinion from your eyes is not fair. My Facebook wall these days is as bad as a WORD WAR. Some people have lost it that badly
that they sound no less than uneducated literates. Looking at them, I realise that social distancing needs to be followed not just in the real world but in the virtual world too.
I want to filter the positive and optimistic messages and leave behind the hopeless ones. We all need to rise above religion, stop defending someone’s deeds, start appreciating humanity else before coronavirus infects all, this hatred would infect us
equally bad. As both these viruses doesn’t come with a cure, so lets be responsible enough to save us from this wicked disease. Lets spread some cheer, love and hope.
On a second thought, this pandemic has made me realise how trivial and tiny we are in front of this tinier virus. This microscopic thing seems mightier than the world. Something so minuscule has so much power that the entire globe is haywire. It makes
me think that power holds no value, neither does money. Coronavirus is neither sparing the influential nor the wealthy.
It looks like a way of God to discipline us - to let us know how much wrong we as humans have done to the planet, to the innocent animals, to the free birds, to the blue skies, to the crystal clear water and to the clean environment. May be its time to
reset the Earth. Lets leave behind the baggage of our mistakes and start afresh. Let the animals live freely and nature breathe once again; lets all learn to co-exist. Lets build a more mindful and responsible world. Lets adapt simplicity and cherish
the joy of our relationships. Read more
Charul Verma has added a new answer
Mom of a 1 yr 7 m old child
8 hours ago
Q. Hello my baby is 20 months old he swallowed a earpod bur he is normal he eat as well as drink please suggest???
Charul Verma
Nutritionist
7 hours ago
A. hi mom
mostly it will be out once he passes stool
but better to show to doctor
it can be checked in x ray if required
Rashmi has added a new answer
Mom of a 1 yr 7 m old child
8 hours ago
Q. Hello my baby is 20 months old by mistake he swallowed a earpod but he is normal is eat drink plz suggest??
Rashmi
Mom of a 9 yr 7 m old girl
8 hours ago
A. It’s fine it should come out into the poop of your child within 24 to 48 hours a lot of mishaps happened with kids these days but these things since they are not edible they do not get digested which is why they come out into the motion
Dr Priyanka Kalra has added a new answer
Guardian of 0 children
7 hours ago
Q. i am 5 months pregnant n i haven't gone for check up even once still now is it okay or should I go
Dr Priyanka Kalra
Obstetrician and Gynaecologist
2 hours ago
A. should go. do ultrasound n necessary tests after consulting a specialist. without proper check up we can't advise or help you.. Avoid shirt cuts when it comes to health if mother n baby. ok. better to show to specialist always as they get the correct diagnosis. try to avoid self and extra medication that will only complicate this and create more damage to the child
Dr Sameer awadhiya has added a new answer
Guardian of 0 children
5 hours ago
Q. my baby is 2 months old and she has developed a white patch on her face. What should I do?
Dr Sameer awadhiya
Paediatrician
4 hours ago
A. White spots on the body and face could be there sometimes, which maybe because of fungal infection or some conditions like pityriasis alba or some other factors some conditions are aggravated by dry skiniu, show a proper mousturisation is required. Also, maintain a proper hygiene and a proper assessment should be done to rule out any other causative factor
Dr Ghouse has added a new answer
Guardian of 0 children
5 hours ago
Q. my baby passes stool after every feed. Is it normal?
Dr Ghouse
Paediatrician
2 hours ago
A. it's ok normal hai jj. if there is no relief it is better you see your doctor for proper examination particularly physical examination if there is need for doing investigations to find out the problem and treatment ok
Dr Ghouse has added a new answer
Guardian of 0 children
2 hours ago
Q. how you can
Dr Ghouse
Paediatrician
1 hour ago
A. question is incomplete please repeat ok. if there is no relief it is better you see your doctor for proper examination particularly physical examination if there is need for doing investigations to find out the problem and treatment ok
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