by Dr Neelima Mantri | Jan 8, 2025 | Blog
Vanishing twin syndrome (VTS) occurs during pregnancy when one twin disappears in the uterus. This condition is usually experienced after it has been initially detected via ultrasound. It is a rare condition and is more prevalent in the first trimester.
For expectant parents, this experience is bittersweet because they are grieving the loss of one twin while celebrating the survival of the other. VTS is relatively common, especially with the use of early ultrasound technology. This article discusses the causes, symptoms, and how families can navigate this journey.
What is vanishing twin syndrome?
Vanishing twin syndrome occurs when a twin or multiple ones disappear in the womb. This is usually because of miscarriage early in the pregnancy. The surviving twin, the placenta, or the mother’s body, absorbs the remaining tissue from the vanished twin.
More cases of VTS have been detected than ever because of the advancement in ultrasound technology. In the past, such cases were not recognized. VTS is most commonly diagnosed during routine scans when multiple gestations are identified, but subsequent scans only show one fetus.
Causes of Vanishing Twin Syndrome
The loss of one twin is typically because of natural factors which no one can control. These are:
- Genetic abnormalities: Some vanished twins have chromosomal issues, which stop them from growing.
- Placental issues: Problems with the placenta, like insufficient blood flow or nutrients not getting to the fetus, can result in the loss of one twin.
- Maternal factors: How advanced in age the mother is, uterine abnormalities or even underlying health conditions of the mother can contribute to VTS. Research shows that this is more common among women who are older than 30.
VTS is rarely preventable and does not indicate a problem with the mother’s health or care.
Symptoms of Vanishing Twin Syndrome
The symptoms vary from person to person, but in most cases, there are no noticeable signs, and it is only discovered during a routine ultrasound. Commonly, some women may experience:
- Vaginal bleeding is often mistaken for a miscarriage.
- Cramp pain or pelvic discomfort.
- Back pain
Diagnosis and Treatment
An early scan may detect two gestational sacs, but subsequent scans may show only one fetus. There is no direct treatment for the vanished twin itself. The only thing that can be done is to monitor the surviving twin. Gynecologists and obstetricians in Mumbai focus on ensuring that the surviving twin develops and that the mother is monitored to prevent any further complications.
In most cases, the surviving twin continues to develop normally, and the pregnancy proceeds without any further complications. There may be the feeling that something could have been done right to prevent the incident from occurring, but it is noteworthy that the irregularities could stem from the vanished twin’s DNA
Conclusion
Vanishing twin syndrome is natural, and for the most part, it cannot be prevented. It may be emotionally challenging, but seeking support can help families go through the experience by focusing on the health of the surviving twin. For the mother’s health, connect with the best gynecologist Mumbai, Dr Neelima Mantri.
by Dr Neelima Mantri | Dec 26, 2024 | Blog, High Risk Pregnancy
Twin Anemia-Polycythemia Sequence (TAPS) is a serious complication that can occur in pregnancies involving monochorionic twins, that is, identical twins sharing a single placenta. It would have you looking for the best obstetrician in Mumbai. This article discusses the causes, symptoms, and treatment of TAPS.
What is the Twin Anemia-Polycythemia Sequence
This condition occurs when tiny blood vessel connections in the placenta cause blood to flow unevenly from one twin to the other. This then makes one twin (the donor) lose blood, leading to anemia, while the other twin (the recipient) ends up with too much blood and that makes their blood thicker than usual—a condition called polycythemia.
It is important to note that TAPS differs from another condition called Twin-to-Twin Transfusion Syndrome (TTTS). While TTTS is caused by larger blood vessel connections between the twins, which often leads to fluid imbalances in the amniotic sacs, smaller connections cause TAPS.
What Causes TAPS?
The primary cause of TAPS is the uneven flow between monochorionic twins. This is due to the tiny surface connections between the placenta’s arteries and veins, which cause blood to flow continuously from one twin to the other twin. Twin Anemia-Polycythemia Sequence can also be caused by a complication after a procedure called laser surgery, which is used to treat Twin-to-Twin Transfusion Syndrome.
The blood vessels are sealed using laser ablation to balance blood flow in the twins. However, the tiny blood connections may remain or develop and lead to TAPS. It is noteworthy that sometimes TAPS spontaneously develops, which shows how unpredictable monochorionic pregnancies are.
Symptoms of Twin Anemia-Polycythemia Sequence
TAPS develops gradually, so it may not show symptoms in the mother early on. However, the anemic twin(the donor) would have pale skin and low hemoglobin levels. The polycythemic twin (recipient) Wood would have a reddish or darker complexion because of thickened blood. In some cases, the placenta on the donor twin’s side may seem thickened, and the recipient twin’s liver may show bright white spots called starry sky.
The Treatment
The treatment depends on the stage of the pregnancy.
These treatments are done during the early stage of the pregnancy. The essence is to help keep both twins stable before delivery:
- Intrauterine Transfusion: For the twin with anemia, a direct blood Transfusion is given in the umbilical vein. This now helps restore hemoglobin levels to normal.
- Partial Exchange Transfusion: This is for the recipient twin who has thick blood. The procedure remixes a portion of the blood and replaces it with a fluid solution like saline or plasma. This would reduce blood viscosity and decrease clotting risk.
- Selective Fetoscopic Laser Surgery (SFL): For advanced cases of TAPS, this procedure is used to target the abnormal blood vessel connections in the shared placenta. A fetoscope (tiny camera) is inserted into the uterus, and a laser is used to seal the problematic vessels.
- Preterm Delivery: Where TAPS occurs towards the end of the pregnancy, the doctors may deliver the babies preterm. They would require intensive care if it comes to this.
Conclusion
The Twin Anemia-Polycythemia Sequence (TAPS) shows how complex monochorionic twin pregnancies can be. However, it shows that one must be vigilant and that timely care can do much good for the babies and the mother. Experienced professionals like Dr. Neelima Mantri have the knowledge and individualized care required for parents managing high-risk pregnancies.
by Dr Neelima Mantri | Dec 23, 2024 | News and Events
Dr. Neelima Mantri, widely recognized as one of the best Gynecologists and Obstetricians in Mumbai, showcased her expertise at the Annual National Conference, held in association with the Varanasi Obstetric and Gynecological Society.
During this prestigious event, Dr. Mantri delivered an insightful and impactful presentation that earned her the Best Paper Award from the Indian Association of Gynecological Endoscopists (IAGE).
Her dedication to advancing the field of gynecology and obstetrics, coupled with her innovative approaches, continues to set benchmarks in the medical community. This recognition reflects her unwavering commitment to improving women’s healthcare and her contributions to gynecological endoscopy.
by Dr Neelima Mantri | Dec 20, 2024 | Blog, Pregnancy Complications
Gestational Trophoblastic Disease refers to a group of rare and abnormal growths that develop during abnormal pregnancy. Though it is uncommon, understanding it is important. It is noteworthy that some GTDs are noncancerous while others are Malignant. This article discusses the types, causes, treatment, and symptoms of gestational trophoblastic disease
The Types of GTD
- Hydatidiform Mole (molar pregnancy): This is the most common form of GTD. It is usually the result of abnormal fertilization of eggs. It results in a mass of cysts. There are two types: partial mole and complete mole.
- Gestational Trophoblastic Neoplasia (GTN): This is a more serious form and can occur after a molar pregnancy. It includes several Malignant growths, such as Invasive moles (invade the uterine wall), Choriocarcinoma (spreads quickly to other parts), placental-site Trophoblastic tumor (forms at the placenta), and Epithelioid trophoblastic tumor (a rare and slow-growing tumor).
The Causes
Several factors contribute to increasing the risk of developing GTD.
- Abnormal fertilization: If an empty egg or multiple sperms fertilize the egg, it may lead to abnormal trophoblastic tissues.
- Maternal age: Women who are under age 20 or above 40 are at risk of developing GTD
- Previous Molar pregnancy: Having a history of molar pregnancy increases the risk of developing another one.
The Symptoms
The symptoms may vary and are dependent on the type and how severe. Common symptoms, however, include:
- Vaginally bleeding: Abnormal vaginal bleeding during pregnancy is one of the most common signs of GTD. It may be spotting or heavy bleeding, and the bleeding may be mistaken for a miscarriage.
- Severe Nausea and Vomiting: Most women with GTD would experience severe morning sickness. This is usually more serious than that of pregnancy nausea.
- Uterine Growth: GTD makes the uterus grow faster than expected fir the stage of pregnancy. This results from the abnormal growth of trophoblastic tissues and may be detected through a physical examination or ultrasound.
- High hCG level: Human Chorionic Gonadotropin(hCG)is a hormone produced during pregnancy. With GTD, the levels would be much higher. It can be confirmed through blood tests and is one major factor used to diagnose the condition
- Pre-eclampsia: Women with GTd may show signs of preeclampsia, like high blood pressure and protein in the urine in the first trimester.
The Treatment
Gestational Trophoblastic Disease treatment depends on the type, the stage it is at when diagnosed, and whether it is benign (not harmful) or Malignant. Treatment is to remove or destroy abnormal trophoblastic tissue, monitor for signs of recurrence, and preserve fertility whenever possible.
Specific treatment methods are:
- Suction Curettage: This is most suitable for molar pregnancy. Abnormal tissue is removed from the uterus using a gentle suction device.
- Chemotherapy: This is more suitable for invasive moles, choriocarcinoma, and other Malignant forms.
- Hysterectomy: This is the removal of the uterus. However, it is not favored by women who would still love to give birth.
- Radiation Therapy: In extremely rare cases, if it has spread to the brain or lungs, surgery isn’t possible, and radiation therapy would be suggested to help target the cancerous cells. This is, however, a thing of last resort where chemotherapy and surgery will not suffice.
Conclusion
Although rare, Gestational Trophoblastic Disease can have serious implications if not treated. However, with early detection, treatment, and follow-up, most women make a full recovery.
Knowing the symptoms and risks of GTD is crucial for ensuring that women seek timely medical attention, leading to better health outcomes and fertility prospects. To get the best female gynaecologist and laparoscopic surgeon in Mumbai, Connect with Dr Neelima Mantri.
by Dr Neelima Mantri | Nov 29, 2024 | Blog, Female Gynaecologist, Pregnancy Tips
Post-surgical Care and Recovery After Endometriosis Surgery
The surgery often performed to remove endometrial tissue to manage complications is just one step ahead in the path toward relief and being pain-free. Proper post-surgical care is important to ensure a smooth recovery. This article provides a guide to understanding what to expect immediately after surgery and tips to help you heal.
Immediate Post Surgical phase
The body needs time to heal from the trauma of the procedure. The first couple of days after endometriosis surgery is critical to set the foundations for recovery.
Post Surgical Symptoms
It is not out of the ordinary to experience different symptoms immediately after surgery. You would experience mild to moderate pain around the incision sites and general abdominal discomfort. This happens because of the surgery itself and the gas used to infante the abdomen. There would be swelling, which typically subsides in a week or two. Some people are unusually tired, and some may feel bloated.
Initial Rest
You need lots of rest to let your body heal, so within the first 48 hours, avoid strenuous activities and prioritize lying down. In addition, you should lean on as much support as you can get. Let your friends or family help out with making meals or running errands. However, you are encouraged to stand from time to time and lightly walk a few steps to help prevent blood slots.
Tips for Physical Recovery
Taking proper care will help the recovery process move along quickly before looking for a gynecologist in Mumbai.
- Diet: Incorporate foods rich in vitamins and minerals into your diet. Anti-inflammatory options like fruits, vegetables, and lean protein help you recover faster. In addition, you should drink a lot of water.
- Movement: Avoid heavy lifting (anything above 10 pounds), strenuous activity, and bending. Instead, take light walks.
- Wound care: Follow your doctor’s instructions to the letter for dressing. It is also important to keep the incisions clean and dry. Do not scrub your incisions while having a bath or apply ointment to them.
- Rest and sleep: Sleep naturally helps the body heal, so get as much sleep as you can. Use supportive pillows to minimize your discomfort.
Monitor your Recovery
You have to be vigilant and aware of when to seek medical attention immediately. If you have mild pain, fatigue, and light spotting, there is no cause for alarm; it is all part of the recovery phase. However, you should contact your doctor immediately if you have persistent pain, excessive bleeding, fever or chills, or unusual swelling, redness, or discharge from the incision.
It is worth mentioning that recovery also includes emotional well-being. There may be feelings of sadness, anxiety or frustration. Be gentle with your body and give it the time it needs to heal properly. If you find yourself being weighed down emotionally due to all the changes, do well to find a support system and even seek professional help.
Final Overview
Recovering from surgery requires a combination of physical care, emotional well-being, and regular follow-ups. It’s important to note that recovery does not follow a straight line. There will be days of progress and moments of challenge. However, with adequate rest, a good diet, and minimal stress, you are on the right path to healing.
Always listen to your body and contact your healthcare provider if you notice your symptoms getting worse or anything unusual. If you are looking for the best lady gynecologist in Mumbai, connect with Dr Neelima Mantri.
