Thursday, May 09, 2013

A vanishing twin? Let's agree on terms!

Case of vanishing twin in Haifa hospital

Published: 05.01.13, 14:43 / Israel News

Physicians at the Rambam Medical Center are fighting for the life of a newborn whose twin brother had died in utero and was partially reabsorbed into his body. Two days ago doctors surgically removed some of the dead fetus' organs, yet they said the baby is still not out of danger.
The hospital staff said some 150 cases of twin embolisation syndrome, or vanishing twin syndrome, are recorded in modern medical history. (Ahia Raved)

This little article is supposed to tell us about a parasitic twin, ( click this link for a case study treated by surgery) but it seems that no one at Israeli news has any idea what the right terms are to use when one twin dies before birth and some body parts are found attached to the body of the survivor.

The "150 recorded cases" may refer to the parasitic twins, but not the many millions of other cases where one twin dies before birth.

These journalists have probably been reading wikipedia - always a mistake to rely on that!!! And shame on them for their ignorance - lazy journalists do a lot of harm. Time was,  if we were not sure we would ask an expert - they asked no one, except some anonymous person on wikipedia who evidently thinks that "twin embolism syndrome" is the same as "vanishing twin" syndrome!


OK.  Here are the correct terms

(My book "Womb twin survivors"  explains all these terms carefully, with diagrams and scholarly references from peer-reviewed journals.)

  • Parasitic twin: A variant of the conjoined or Siamese twin. Occurs only in monozygotic twins. Some parts of one twin are attached to or within the body of the co-twin. ( an example)

  • Twin embolization syndrome. Twin embolization syndrome is a complication of monozygotic twinning following in utero death of the co-twin.  Basically, blood clots, or even dead tissue, can pass into the body of the sole survivor if the major blood vessels have become connected via the placenta.
  • Vanishing twin syndrome: A term coined in 1980 to described the specific situation where a twin pregnancy is seen on ultrasound scan but a few weeks later there is only one baby.  This can  happen in any kind of  twin or multiple pregnancy - identical or fraternal.  A common sign is vaginal bleeding in the pregnant mother.
 This confusion is the reason why I chose "womb twin survivor" as the term to describe the sole survivor of any of these situations.  It is more general, and therefore more accurate, to describe all individuals with this specific prenatal experience, and can include stillbirth, neonatal death, miscarriage and abortion.

Even at the earliest stages, twins don't just "vanish." They die. They may be no longer visible on ultrasound, but often their remains can be seem after birth.

Does that help?  I do hope so.

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