The Recognition And Significance Of The Vanishing Twin

Abstract: With the advent of sonography, a twin pregnancy may be diagnosed in early gestation. Se-rial sonographic examinations can show the disap-pearance of one of two twins. We offer evidence of an early twin pregnancy with a "vanishing twin, " re-sulting in a liveborn singleton plus a fetus papyra-ceus. There is an increasing body of information about explanations, management, and complications associated with a multiple gestation and fetal death. The rate of multiple gestation is being redefined since the advent of sonography. It is now well known that more twins are lost in early pregnancy than previously believed and that many appar-ently singleton pregnancies began as a twin preg-nancy. A review of the literature by Landy, et al. noted that the simultaneous occurrence of a fetus papyraceus and a live twin is extremely rare and reported to be 1: 12,000 live births. I In this re-port, we present a case of a twin gestation result-ing in the birth of a healthy singleton and a fetus papyraceus. Fetus papyraceus is defined as the fetal death of one fetus in a twin pregnancy, with compression of the blighted twin by the growth of the living twin. The result is a flattened body resembling parchment. Serial sonographic examinations al-lowed the course of this pregnancy to be followed. Had the original sonogram not been done, the twin pregnancy could have been missed. Knowl-edgeable management of such pregnancies is of increasing importance. Case Report The mother was healthy, married, aged 37 years