Ultrasound Observations in Multiple Gestation with First Trimester Bleeding: The Blighted Twin

Abstract

Patients (22), 19 of whom presented with 1st trimester bleeding, underwent ultrasound examination demonstrating a normal amniotic cavity containing a fetus with regular heart activity. In each, a separate anechoic or hypoechoic region was identified within the uterus compatible with a coexistent anembryonic pregnancy or blighted twin. Three patterns, 2nd sac, crescent of fluid outlining the intact sac and septal division of the amniotic cavity with 1 compartment empty, were described. Additional cases (7) with variant situations were discussed. The diagnosis of blighted twin carries a good prognosis for carrying the single gestation to term.