📄 SCRS
Vanishing Twin Syndrome
Vanishing Twin Syndrome ultrasound case study
USG
Vanishing Twin Syndrome ultrasound case study
Case Study Record
| SN | Case Name | Report Line |
|---|---|---|
| 1 | Vanishing Twin Syndrome (Gestational Sac Only) | View Report Line |
| 2 | Vanishing Twin Syndrome (Gestational Sac with Embryo) | View Report Line |
| 3 | Vanishing Twin Syndrome with a Viable Co-Twin | View Report Line |
| 4 | Vanishing Twin Syndrome (Failure of interval growth) | View Report Line |
| 5 | Marked intertwin growth discordance | View Report Line |
CASE–1
Vanishing Twin Syndrome (Gestational Sac Only)
Vanishing Twin Syndrome (Gestational Sac Only)
Clinical History
A 28-year-old gravida 1 para 0 female at 11 weeks of gestation presented for a routine first-trimester obstetric ultrasound. An earlier scan had demonstrated an early twin gestation. The patient reported mild vaginal spotting that had resolved spontaneously and denied significant abdominal pain.
Ultrasound Findings
Ultrasound examination demonstrates a single viable intrauterine pregnancy with fetal biometric parameters appropriate for the gestational age and normal fetal cardiac activity. Adjacent to the viable gestational sac, a second small collapsed gestational sac is identified without a yolk sac or fetal pole. The sac demonstrates irregular margins and features of resorption. No subchorionic hematoma is seen. Both ovaries appear unremarkable, and no free fluid is identified within the pelvis.
Report Line
A live intrauterine fetus with appropriate growth and normal fetal cardiac activity is demonstrated. A second collapsed gestational sac is seen without a yolk sac or embryo, consistent with resorption of a nonviable co-twin. The findings are compatible with vanishing twin syndrome (gestational sac only).
Impression
Vanishing twin syndrome (gestational sac only). A viable singleton intrauterine pregnancy is present with an adjacent collapsed empty gestational sac representing a resorbing nonviable co-twin.
Go To Table
Recommendation
Routine obstetric follow-up with serial ultrasound examinations is recommended to monitor the ongoing singleton pregnancy. The prognosis for the surviving fetus is generally excellent when vanishing twin syndrome occurs during the first trimester. Clinical review is advised if significant vaginal bleeding, abdominal pain, or other concerning symptoms develop.
Key Learning Points
- Vanishing twin syndrome may present as a residual empty gestational sac without a yolk sac or embryo.
- The gestational sac progressively collapses and is gradually resorbed during pregnancy.
- The surviving singleton fetus usually demonstrates normal growth and cardiac activity.
- Most first-trimester cases have an excellent prognosis for the remaining fetus.
- Serial ultrasound examinations confirm continued fetal growth and gradual disappearance of the residual gestational sac.
- Patient counseling and reassurance are important aspects of management.
CASE–2
Vanishing Twin Syndrome (Gestational Sac with Embryo)
Vanishing Twin Syndrome (Gestational Sac with Embryo)
Clinical History
A 30-year-old gravida 2 para 1 female at 10 weeks of gestation presented for a routine first-trimester obstetric ultrasound. A previous ultrasound had demonstrated a twin gestation. The patient reported mild intermittent vaginal spotting without significant abdominal pain. Follow-up ultrasound was performed to assess fetal viability.
Report Line
A viable singleton intrauterine pregnancy is identified with appropriate fetal growth and normal cardiac activity. A second gestational sac contains a nonviable embryo without cardiac activity and demonstrates partial collapse, consistent with embryonic demise. These sonographic findings are compatible with vanishing twin syndrome (gestational sac with embryo).
Impression
Vanishing twin syndrome (gestational sac with embryo). A viable singleton intrauterine pregnancy coexists with a second gestational sac containing a nonviable embryo, consistent with spontaneous demise of one twin during early pregnancy.
Go To Table
CASE–3
Vanishing Twin Syndrome with a Viable Co-Twin
Vanishing Twin Syndrome with a Viable Co-Twin
Clinical History
A 30-year-old gravida 2 para 1 female at 10 weeks of gestation presented for a routine first-trimester obstetric ultrasound. A previous early pregnancy scan had demonstrated a diamniotic twin gestation. The patient reported a brief episode of mild vaginal spotting one week earlier, with no significant abdominal pain or passage of tissue. Follow-up ultrasound was requested to assess fetal viability and pregnancy progression.
|
| Twin B:. Twin B demonstrates a CRL of approximately 34 mm (10w 2D) with absent cardiac activity, compatible with fetal demise. Twin B remains viable, consistent with vanishing twin syndrome. |
|
| Twin A: Twin A demonstrates a single live intrauterine fetus with biometric parameters as follows: BPD 31.29 mm, HC 105.9 mm, AC 88.6 mm, and FL 14.4 mm, corresponding to a composite gestational age of 15 weeks 3 days. The estimated date of delivery (EDD) by composite ultrasound age is 21-12-2026. The estimated fetal weight (EFW) is 105.56 ± 15.8 grams. Fetal cardiac activity is present with a fetal heart rate (FHR) of 167 bpm. Amniotic fluid volume is within normal limits. Twin B demonstrates features of fetal demise with a collapsed gestational sac/fetal remnant, consistent with vanishing twin syndrome. |
|
| Single live intrauterine fetus: A single loop of the umbilical cord is seen encircling the fetal neck (single-loop nuchal cord). Fetal cardiac activity is present with a normal heart rate. Fetal movements and amniotic fluid volume are within normal limits. |
Report Line
A live intrauterine fetus is demonstrated with biometric parameters corresponding to 15 weeks 3 days gestation. Fetal cardiac activity is present (FHR: 167 bpm) with normal amniotic fluid volume. A second gestational sac contains a collapsed fetal remnant without cardiac activity, consistent with fetal demise. These findings are in keeping with vanishing twin syndrome with a viable co-twin.
Impression
Vanishing twin syndrome with a viable co-twin. One live intrauterine fetus of approximately 15 weeks 3 days gestation is identified with normal cardiac activity, while the second twin demonstrates fetal demise with a collapsed gestational sac/fetal remnant, compatible with vanishing twin syndrome.
Go To Table
CASE–4
Vanishing Twin Syndrome (Failure of Interval Growth)
Vanishing Twin Syndrome (Failure of Interval Growth)
Clinical History
A 31-year-old gravida 2 para 1 female presented for a follow-up obstetric ultrasound at 15 weeks of gestation. A previous first-trimester ultrasound had demonstrated a viable twin pregnancy. The current examination was requested to assess interval fetal growth and viability. The patient was asymptomatic except for a history of mild vaginal spotting during early pregnancy.
Report Line
Follow-up ultrasound demonstrates one viable intrauterine fetus with appropriate interval growth and normal fetal cardiac activity. The co-twin demonstrates failure of interval growth compared with the previous examination, with absent fetal cardiac activity and sonographic features of fetal demise. These findings are compatible with vanishing twin syndrome secondary to failure of interval growth of the co-twin.
Impression
Vanishing twin syndrome (Failure of Interval Growth). One viable intrauterine fetus demonstrates appropriate interval growth, while the co-twin shows failure of interval growth with absent cardiac activity, consistent with intrauterine fetal demise and subsequent vanishing twin syndrome.
Go To Table
CASE–5
Vanishing Twin Syndrome (Marked Intertwin Growth Discordance)
Vanishing Twin Syndrome (Marked Intertwin Growth Discordance)
Clinical History
A 30-year-old gravida 2 para 1 female presented for a follow-up obstetric ultrasound at 16 weeks of gestation. A previous examination had demonstrated a twin pregnancy. The current scan was performed to evaluate fetal growth and well-being after concern regarding discordant fetal development on an earlier study.
Report Line
Follow-up ultrasound demonstrates one viable intrauterine fetus with appropriate interval growth and normal fetal cardiac activity. The co-twin demonstrates marked intertwin growth discordance, measuring significantly smaller than expected for gestational age with absent fetal cardiac activity and sonographic features of fetal demise. These findings are consistent with vanishing twin syndrome associated with marked intertwin growth discordance.
Impression
Vanishing Twin Syndrome (Marked Intertwin Growth Discordance). One viable intrauterine fetus demonstrates appropriate growth and normal cardiac activity, while the co-twin is markedly growth restricted with absent cardiac activity, consistent with fetal demise and subsequent vanishing twin syndrome.
Go To Table
No comments:
Post a Comment