Vanishing Twin Syndrome (VTS)

Disappearing Twin Syndrome

Twin pregnancy ultrasound
Twin Discordance. Photo © Robin Elise Weiss

What is Vanishing Twin Syndrome (VTS)?:

Vanishing Twin Syndrome (VTS) is where one baby or fetus from a multiple gestation disappears or "vanishes" after the diagnosis of a multiple pregnancy via ultrasound. The baby is typically reabsorbed by the mother, the placenta and occasionally the surviving twin.

How is Vanishing Twin Syndrome (VTS) diagnosed?:

If a twin pregnancy was known, Vanishing Twin Syndrome (VTS) may be diagnosed at a subsequent visit when studies via ultrasound or doppler failed to hear a second heart beat.

There are also mothers who experience vaginal bleeding or cramping and come in for additional prenatal care to ascertain the source of the bleeding or cramping.

How frequently does Vanishing Twin Syndrome (VTS) occur?:

It is estimated that 20-31% of all multiple pregnancies will have a problem with Vanishing Twin Syndrome (VTS). Though in truth it is very difficult to pin down an exact number because of a variety of factors including undiagnosed twins, higher order multiples, misdiagnosis of the cause of bleeding, etc.

Can Vanishing Twin Syndrome (VTS) be prevented?:

The belief is that the majority of Vanishing Twin Syndrome (VTS) is due to a genetic or placental issue with the lost twin. Therefore it is nearly impossible to prevent the loss of this baby. It has also not been found to be associated with age or race.

What happens to the pregnancy after Vanishing Twin Syndrome (VTS)?:

If the twin vanishes in the first trimester there are rarely any lasting effects on the pregnancy.

Sometimes Vanishing Twin Syndrome (VTS) can have a negative effect on certain blood screenings like the alpha-fetoprotein testing for neural tube defects and Down Syndrome in the early second trimester.

Vanishing Twin Syndrome (VTS) in the second half of pregnancy can be related to:

  • bleeding difficulties in mother
  • cerebral palsy in the surviving twin

A D & C should not be performed if there is a viable baby in the uterus. Ultrasound follow up of the surviving twin is needed.

What are common emotions after Vanishing Twin Syndrome (VTS)?:

It can be normal to feel a variety of emotions after experiencing a pregnancy loss while maintaining a healthy pregnancy. You may feel like you are relieved that you have a healthy baby and yet also sad at the loss of another baby and the idea of having twins.

How long you feel sad can vary widely. Some mothers grieve and move on more quickly than others, while some mothers are sad for a very long time. It is also normal to have feelings that come and go, particularly at the birth, ultrasounds, birthdays, etc. Everyone will have a variety of triggers.

Where can I find help with Vanishing Twin Syndrome (VTS)?:

You may want to go here for help:

National Organization of Mothers of Twins Clubs (NOMOTC)


Abbas A, Johnson M, Bersinger N, Nicolaides K. Maternal alpha-fetoprotein levels in multiple pregnancies. Br J Obstet Gynaecol. Feb 1994;101(2):156-8.

Newton R, Casabonne D, Johnson A, Pharoah P. A case-control study of vanishing twin as a risk factor for cerebral palsy. Twin Res. Apr 2003;6(2):83-4.

Sulak LE, Dodson MG. The vanishing twin: pathologic confirmation of an ultrasonographic phenomenon. Obstet Gynecol. 1986 Dec;68(6):811-5.

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