Vanishing Twin Syndrome Treatment & Management

Updated: Apr 12, 2021
  • Author: Ann L Anderson-Berry, MD, PhD; Chief Editor: Christine Isaacs, MD  more...
  • Print

Medical and Surgical Care

Medical care

Uncomplicated vanishing twin syndrome requires no special medical care.

If a fetus papyraceus remains, the pregnancy should be followed closely with serial ultrasonographic evaluation of the live fetus. Risks include premature labor, obstruction of labor, or death of the surviving fetus due to placental abruption or chorioamnionitis. [36]  This fetus is also at risk for low birth weight and small for gestational age (SGA), with increasing risk in the surviving twin for vanishing twin occurring later in gestation. [37, 38]

The provider should watch carefully for infection and consumptive coagulopathy.

Instruct pregnant women to seek medical care for vaginal bleeding, cramping, and pelvic pain.

The viable twin should receive specialized medical care as indicated by initial physical examination and subsequent mental and physical development.

Anand et al reported in 2007 that surviving cotwins had poorer scores on the Griffiths Mental and Development Scales when compared with singleton pregnancies. [39]


Evaluate pregnant women with vaginal bleeding at a site with adequate ultrasonographic capabilities.

Surgical care

Only perform dilation and curettage after ultrasonographic confirmation that a viable embryo or fetus does not exist. [27]