Single intrauterine foetal death at the second trimester in a twin pregnancy: Case report

Abstract

A vanishing twin, or foetal resorption, is a foetus in a multi-gestation pregnancy which dies in-utero and is then partially or completely reabsorbed. Single foetal death in the second and third trimester is associated with a higher risk of maternal and foetal morbidity and mortality in the first trimester. The most dreaded maternal complication is Disseminated Intravascular Coagulation (DIC) while the surviving co-twin may be at risk of demise in the same intrauterine environment. This case decribes challenges in management of a second trimester single intrauterine foetal death in a Dichorionic diamniotic (DC) twin pregnancy in a resource-limited setting which resulted in spontaneous vaginal delivery at term with no identified maternal or foetal complications. The management in a limited resource setting is challenging. The risk of prematurity should be weighed against the risk of keeping the surviving co-twin in the same intrauterine environment and management should include psychosocial support. Keywords: single foetal death; twin pregnancy; case report.