Pregnancy loss in twin or triplet pregnancies is more common than in a singleton pregnancy. Multiple pregnancies carry more risks, meaning complications can occur which can result in miscarriage or stillbirth.
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The causes of loss
Potential causes of losing one of your babies can include:
- Vanishing Twin Syndrome: This occurs when one of the embryos or foetuses in a multiple pregnancy stops developing and is absorbed by the mother's body or the other twin. This is most common in the first twelve weeks of pregnancy.
- Twin-to-Twin Transfusion Syndrome (TTTS): TTTS occurs in identical twins who share a placenta. It happens when there's an imbalance in blood flow between the twins, leading to one twin receiving too much blood (the 'donor' twin) and the other receiving too little (the 'recipient' twin). If left untreated, TTTS can result in the loss of one of you twins.
- Intrauterine Growth Restriction (IUGR): If one baby is not receiving enough nutrients or oxygen, they may not grow as well as the other(s), leading to complications and potentially the loss of that baby.
- Congenital abnormalities: One baby may have a severe congenital abnormality or genetic disorder leading to loss, while the other baby or babies may continue to develop normally.
- Placental insufficiency: If the placenta that supports one baby is not functioning properly, that baby may not receive enough oxygen and nutrients, leading to growth restrictions, complications and possibly loss.
You can learn more about complications in multiple pregnancy by downloading our Complications booklet [insert link and button].
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What happens when a twin or one or two of a set of triplets dies during pregnancy?
When one twin dies or one or two of a set of triplets dies during the first 12 weeks of a pregnancy it doesn't usually affect the development of the remaining twin or triplet(s). In a twin pregnancy this is known as 'vanishing twin syndrome'. It happens when twins are detected at a very early scan, but only one baby is found at the dating scan.
You may not even know that one of your twins or one or two of your triplets have died, having experienced few or no symptoms. That's why it can come as a huge shock and it's not unusual to feel uncomfortable or ashamed if you didn't realise one of your twins or one or two of your triplets have died. However, most parents do not suspect anything is wrong until the ultrasound examination reveals the devastating news that they have lost a twin or triplet(s).
Stats on pregnancy loss
Sadly, pregnancy loss in the first 12 weeks is common. The risk of losing a baby in the first two trimesters of a twin pregnancy is slightly higher than with a single pregnancy. Women expecting multiples are 2.25 times more likely to experience stillbirth than singletons, according to the MBRRACE 2020 report.
Losing a twin or one or two of a set of triplets in the second or third stages of pregnancy
Losing a twin or one or two of a set of triplets during the second and third trimesters of your pregnancy carries higher risk for the remaining twin or triplet(s). You'll receive closer monitoring and doctors will assess whether it is safer for your baby or babies to remain in the womb for longer, or be born early. This can be a very upsetting time for parents and not knowing 'why' your baby or babies died can be painful.
You may worry about your remaining twin or triplets' health, and without an explanation for the sudden death, it's natural to feel vulnerable and scared. Although your pregnancy is at a higher risk, many babies whose sibling(s) have died in the second or third trimester are born healthy.
