Miscarriage With Twins: Odds, Reasons, Symptoms, Risk Factors

| Reviewed By Amanda Lundberg, BSN, RN

The possibility of miscarriage causes fear in the hearts of many expectant parents. Unfortunately, many pregnancies end in miscarriage, and this is also true for those carrying multiples.

While it is a delicate topic, like most fears, getting more education about miscarriages can help set expectations as well as heal hurting hearts. 

Can you be pregnant with twins and miscarry? Miscarrying one twin and carrying the other baby to term is possible. Typically, the loss of one twin happens very early in the pregnancy, often before a mother even knows she is pregnant. This phenomenon is called Vanishing Twin Syndrome. Miscarrying a twin later in pregnancy is much rarer.

Many struggles of pregnancy and parenthood are helped when people find common ground with others who have walked where they are walking.

The pain of a miscarriage cannot be taken away by reading an article about it, but perhaps some facts could help. 

Twin Pregnancy and Miscarriage – What To Know

Miscarriage is a risk in any pregnancy. Twin pregnancies or any pregnancy with multiples is often considered high risk for many reasons, with miscarriage being one of the many concerns.

The presence of more than one fetus in a womb also increases the likelihood that a mother will miscarry. 

Is Miscarriage Common with Twins?

Unfortunately, miscarriage is more common in twin pregnancies than in single-fetus pregnancies.

Odds of Miscarrying Both Twins 

There is only a 5-10% chance of losing both twins to miscarriage. This knowledge could help relieve any anxiety you may be feeling.

Instead of focusing on the small possibility of miscarrying both babies, focus on the 90-95% chance that this will not occur.

Odd of Miscarrying One Twin 

There is a greater chance of losing one twin in a twin pregnancy than there is of losing both twins. Doctors call this Vanishing Twin Syndrome in which one twin is lost, usually early in the pregnancy.

The probability of this condition is higher at 20%-30%. This rate of miscarriage is almost double that of pregnancies involving a singelton baby. 

What Is Vanishing Twin Syndrome?

Vanishing Twin Syndrome is the loss of one twin in a pregnancy. Usually, this occurs in the first trimester and often before a mother even knows she is expecting twins.

If a baby in a multiple pregnancy is lost later in the pregnancy (after 20 weeks) the loss is typically called a twin loss. 

What Causes Vanishing Twin Syndrome? 

The exact cause of Vanishing Twin Syndrome is not known. Doctors speculate that it occurs when one twin has chromosomal abnormalities that would not sustain life and the other is healthy.

Experts usually attribute this condition to either genetic abnormalities in the baby or possibly improper umbilical cord implantation. 

How Common Is Vanishing Twin Syndrome?

Roughly, 20-30% of twin pregnancies will experience Vanishing Twin Syndrome. In my close friend’s twin pregnancy 6 years ago, Baby B (a girl) had a “significantly lower heart rate” at their 6-week ultrasound.

The doctor prepared her to come back at 8 weeks and see that her baby had, in fact, vanished. We all count ourselves so blessed that her heartbeat was perfectly strong at the 8-week checkup and has beat strongly ever since! 

Symptoms of Vanishing Twin Syndrome

Because this event usually happens so early in pregnancy, there often aren’t many noticeable symptoms. Some women might cramp or bleed, a bit but both of those symptoms can be common during the first weeks of pregnancy.

The only way to actually document Vanishing Twin Syndrome is through ultrasound as blood levels aren’t sensitive enough to detect the change. 

When Does Vanishing Twin Syndrome Occur? 

Vanishing Twin Syndrome typically occurs very early in the pregnancy, sometimes before a mother even knew she was expecting twins. The vast majority of cases of Vanishing Twin Syndrome occur before 12 weeks.

Will the Remaining Twin Survive?

As previously mentioned, the likelihood of losing the second twin after Vanishing Twin Syndrome is very rare at 5-10%. Twins who vanish usually have chromosomal or genetic abnormalities that cause the pregnancy to end. 

Does Miscarriage Happen Suddenly? 

Miscarriage can happen rather quickly, or it can be a process that takes a couple of weeks. Vanishing Twin Syndrome is most often believed to happen very quickly in the pregnancy. 

Can a Miscarriage Be Stopped? 

Once a miscarriage has started, there is no way to stop it. The signs of miscarriage are the final sign that the pregnancy is not developing successfully and has already ended.

It is always important to remind women that a miscarriage is not the result of them doing something wrong and it is not their fault. 

When Does Miscarriage Risk Drop? 

The risk of miscarriage drops dramatically after the first trimester or 12 weeks of pregnancy, and 80% of miscarriages occur in the first 12 weeks. Any pregnancy loss after 20 weeks is considered to be a stillbirth, not a miscarriage. 

Risk Factors for Miscarriage

Some women are at a higher risk for both miscarriage and Vanishing Twin Syndrome. Women over the age of 35 typically have a greater risk of miscarrying.

Other risk factors include chronic conditions, previous history of miscarriages, and the mother being either overweight or underweight.

Some women who have cervical or uterine complications might have a higher risk of miscarriage. Women who use illicit drugs or alcohol when pregnant are more likely to have a pregnancy loss. 

Miscarriage Symptoms in the First Trimester

Symptoms of an early pregnancy loss are vaginal bleeding and spotting. This spotting is often accompanied by cramps in the lower back and abdomen. The final symptom is fluid or tissue passing through the vagina. 

Related Questions:

Can You Miscarry and Still Be Pregnant?

You can miscarry and still be pregnant if you are having multiples. One baby can survive while the other twin vanishes.

However, if you are pregnant with just one baby and that pregnancy stops developing for any reason, your body will expel the baby or your doctor will remove the baby in a procedure. 

Do Miscarriages Run In Families?

There is some research that proposes that the predisposition to miscarry can be passed from mother to daughter.

However, over 50% of miscarriages occur because of genetic abnormalities that occur as the embryonic cells split and divide, not from a hereditary condition. 

Final Thoughts

Twin pregnancies often come with a lot of complications. For this reason, they are monitored more closely and considered high risk. Miscarriage is just one of the many risks associated with carrying twins.

Should this ever be a part of your story or of someone close to you, please do some research to make yourself or your loved one feel less alone.

Miscarriage is hard enough on its own and feeling isolated in that will not help anyone heal.