can vanishing twin be misdiagnosed

That means that in many cases of vanishing twin, parents and doctors never know. Home; Products; Case Studies; About Alocore; Contact Hello world! I went to the bathroom and saw blood. This is a twin pregnancy, in which one baby is viable and the other twin is miscarried. Pregnant women should seek medical care if they are experiencing bleeding, cramping, and pelvic pain. I'm from the January 2015 board and was told at my dating ultrasound that they could see two sacs and one had a baby measuring 6w5d and the other only had a fetal pole and would be a vanishing twin. Join online support groups to talk about the grief youre feeling. Sometimes identical twins can be assigned the sex of male and female at birth. Knowing what you can about vanishing twin syndrome can . The prognosis of the surviving twin is usually excellent, but this depends on the factors that contributed to the death of the other twin. One baby doesn't make it, and the twin who was miscarried is considered the vanishing twin. Last edited 10/30/14. The explaination was that it was entirely possible that the haematoma and sac combination was a disappearing twin. With a parasitic twin, two embryos begin developing together. The twin that stops growing will be reabsorbed into your placenta and into the baby that youre carrying. Ultrasound Obstet Gynecol. The embryo stops developing, and its tissue gets absorbed by the mother, or gestational parent, and the surviving embryo . . Can you see vanishing twin on ultrasound? Hyperovulation has few symptoms, if any. So it could happen, and no one would ever know, she says. Then suddenly, there was only me., For as long as she can remember, Erin has known she was missing her other half. If at all possible, be extra gentle on yourself physically and emotionally in the days after you find out youve lost a twin. Causes and statistics for late term miscarriages vary widely. All rights reserved. If one twin dies during the first trimester, the outlook for mom and the other twin is still very good. Abnormal chromosomes can cause one twin to die early in a pregnancy. Remember that youre not just taking care of you youre still growing a baby inside of you. Cell-free DNA testing of maternal blood in screening for trisomies in twin pregnancy: updated cohort study at 10-14weeks and meta-analysis. A second ultrasound is conducted, and only one fetus is observed. Judah H, Gil MM, Syngelaki A, Galeva S, Jani J, Akolekar R, Nicolaides KH. One study suggested it occurred about 20-30% of twin . But if your doctor has confirmed that youre carrying multiples and you then experience symptoms of cramping and some bleeding, its possible one of the embryos has stopped developing. We are using cookies to give you the best experience on our website. mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/twin-pregnancy/art-20048161, seattlechildrens.org/globalassets/documents/healthcare-professionals/vanishing-twin-syndrome.pdf, Seeing Double: How to Increase Your Chances of Having Twins, What Are the Symptoms of Hyperovulation?, Pregnancy Friendly Recipe: Creamy White Chicken Chili with Greek Yogurt, What You Should Know About Consuming Turmeric During Pregnancy, Pregnancy-Friendly Recipe: Herby Gruyre Frittata with Asparagus and Sweet Potatoes, The Best Stretch Mark Creams and Belly Oils for Pregnancy in 2023, Why Twins Dont Have Identical Fingerprints. Only the dr. My friend lost a twin early on and went on to have a healthy pregnancy. One baby was miscarried during the pregnancy without the mothers or doctors knowing. How many weeks does vanishing twin happen? In "Having Twins." author Elizabeth Noble claims that 80% of twin pregnancies result in the loss of one or both babies. Yolk sac number should not be used to determine amnionicity. We strive to provide you with a high quality community experience. A follow-up ultrasound may reveal the disappearance of a twin. If it occurs in thefirst trimester, for example, neither mother nor remaining fetus will typically show any signs or symptoms. 2016 Jun;47(6):705-11. doi: 10.1002/uog.15913. We will see if perhaps it was a wrong diagnosis! For most miscarriages, we never know the reason why, but over50 percent of pregnancies that miscarry have a chromosomal abnormality, she tells HealthyWay. For 50-year-old mother Jamie (whose name has been changed for her privacy) of New Jersey, bleeding at seven weeks was the first sign something wasnt right. Finding out youre carrying more than one child might have intimidated or thrilled you. In the second and third trimesters, its a more dangerous situation that will have to be monitored and managed with care. Other ideas for coping with vanishing twin syndrome: Vanishing twin syndrome is more common than many people realize. So it does happen. Yes, I had a misdiagnosed miscarriage. Misdiagnosis Based on hCG Levels The woman can choose to wait for a natural miscarriage in many cases. Discovering one of the babies has stopped growing can cause feelings of grief. 1. 252: changing patterns of invasive fetal diagnostic testing in the era of NIPT. As a result, a developing fetus can end up with DNA that cant develop the way that it needs to. Denise (who asked to remain anonymous), a 34-year-old mom from Chicago, can still recall the panic she experienced eight weeks into her first pregnancy. It's a site that collects all the most frequently asked questions and answers, so you don't have to spend hours on searching anywhere else. A week later I had some spotting (mostly brown) so went in to my doc just to check. Should the loss happen during the second or third trimester, however, the fetus could be at greater risk of developingcerebral palsy oraplasia cutis. Among the 12 cases in which cfDNA was performed at two time points, fading of contaminating cfDNA was observed in four cases with a sex discrepancy and in one false positive for trisomy 18, resulting in a final correct result. The material on this site can not be reproduced, distributed, transmitted, cached or otherwise used, except with prior written permission of Solid Ventures. For others, its a big relief due to the stress which a mother may feel. Sarno L, Revello R, Hanson E, Akolekar R, Nicolaides KH. And it can have a potentially devastating outcome. When these miscarriages happen early enough, the demised baby will dissolve and be reabsorbed into the mother, making it look like the baby simply vanished. The difference here, according to Martin, is that unlike most miscarriages, where the pregnancy is passed through the birth canal, in vanishing twin syndrome, it happens on the inside. Thank you so much for the bump! Genomics-based non-invasive prenatal testing for detection of fetal chromosomal aneuploidy in pregnant women. The incidence of miscarriage in the twin pregnancies, expressed per gestational sac, was 11.1%. Badeau M, Lindsay C, Blais J, Nshimyumukiza L, Takwoingi Y, Langlois S, Lgar F, Gigure Y, Turgeon AF, Witteman W, Rousseau F. Cochrane Database Syst Rev. If it happens early enough in the pregnancy, you may not have any idea you were ever carrying two babies. Hang in there! But the syndrome has since gained more traction, as the use of ultrasonography has led to more frequent diagnoses. Im good., While Denise was grateful she wasnt losing the pregnancy, she notes the following visit was somewhat tougher to process. She explains that a vanishing twin is essentially amiscarriage of one baby in a twin pregnancy (either resulting from spontaneous conception or IVF). A vanishing twin can cause feelings of confusion, anxiety, and grief for people who have been told theyre carrying multiple pregnancies. Small indicators of the twin might remain in your placenta when you deliver your baby. The pregnancy becomes a singleton pregnancy, and the physical and emotional impact on the parents can be devastating. However, you may not have an appointment to check for the heartbeat until later in the first trimester. The fetal tissue is absorbed by the other twin, multiple, placenta or the mother. I would call and get seen ASAP. Cell-free DNA testing is a recently introduced method for screening pregnant women for fetal trisomy, which is associated with some common significant genetic diseases, as well as the sex of the fetus. A heartbeat can be detected fairly early in a pregnancy, sometimes around five or six weeks. We work hard to share our most timely and active conversations with you. 2021 Sep;41(10):1233-1240. doi: 10.1002/pd.5989. Not me, but that would be pretty cool. The loss of a twin during the first trimester of pregnancy doesnt usually affect the development of the surviving baby . However, theres no evidence to show that the living twin will be affected. We respect everyones right to express their thoughts and opinions as long as they remain respectful of other community members, and meet What to Expects Terms of Use. and transmitted securely. Contaminant DNA contribution from the demised co-twin was studied in detail. Vanishing twin syndrome was first recognized in 1945. The cause of the syndrome is unknown, but some possibilities have yet to be eliminated such as a small placenta or . Finding out the specific reasons for vanishing twin syndrome, however, isnt so straightforward, as its difficult to test. Do Men Still Wear Button Holes At Weddings? Some factors . My prayers are going to you and your babies. Twin pregnancies carry more risks than singleton pregnancies. A missed diagnosis describes the lack of a diagnosis, usually leading to no or inaccurate treatment. Once established, unnecessary invasive procedures could be avoided, mitigating negative emotional impact on future mothers. How long you bleed after a miscarriage depends on different factors. What are the two convention centers in Boston? If an early ultrasound shows a twin pregnancy, but a mother experiences symptoms of miscarriage or lower-than-expected hCG levels, or only one heartbeat can be detected via Doppler, a doctor may suspect vanishing twin syndrome. While one twin was clearly visible, the other was murky, she recalls. N Engl J Med 2014;371(6):578. Please enable it to take advantage of the complete set of features! In many cases, you wont know youve experienced VTS. Hello. A vanishing twin is related to but different than whats called a parasitic twin. All rights reserved. My Dr had me go back at 6w 5d . The difference in gestational sac diameter averaged 1.2 +/- 0.1 mm for pregnancies which ended in twin births, compared to 2.0 +/- 0.3 mm when pregnancy ended in single births (P less than 0.02). I had our first u/s at just over 6 weeks and there were 2 visible heart beats (pic below) and now carrying 22w b/g twins. If the loss occurs within the first trimester, neither the remaining fetus nor the mother generally has clinical signs or symptoms. In some instances, the dead twin is compressed into a flattened, parchment-like state known as fetus papyraceus.. Vanishing twins occur in up to one of every eight multifetus pregnancies and may not even be known in most cases. Can you abort one twin and keep the other? The site is secure. This site needs JavaScript to work properly. Now I am 31weeks with di/di boys. Hoping for the best! Both aneuploidy analysis (chromosomes 13,18, 21, X, and Y) and fetal fraction estimation were performed according . Please whitelist our site to get all the best deals and offers from our partners. The doctor explained that while one held a heartbeat, the other did not. This discussion is archived and locked for posting. This frittata is high in protein and rich in essential nutrients your body needs to support a growing baby. These highs and lows are hard to take, she says. The fetal tissue is absorbed by the other twin, multiple, placenta or the mother. Bonus: You can. When a twin dies after the embryonic period of gestation, the water within the twins tissues, the amniotic fluid, and the placental tissue may be reabsorbed. When studying human behavior, behavioral geneticists often employ twin and adoption studies to research questions of interest. . Consuming turmeric in pregnancy is a debated subject. I was just so happy I wasnt losing the pregnancy that it really wasnt emotionally that hard on me, she recalls. Group Owners uphold the core values of the brand by reporting content that violates the community guidelines. Most the time I hear about it, it's because it was to early for the second twin, so they say "vanishing" when really it was just further behind. The risk of losing a baby in the first two trimesters of a twin pregnancy is slightly higher than with a single pregnancy. Once you miscarry, there is no chance of the baby reappearing. Up until that point it was always "wait and see". Vanishing twin syndrome can occur throughout the pregnancy, but it often happens before the first ultrasound. Neonatal nursing education brief: Vanishing twin syndrome. Although it is rare, miscarriage can be misdiagnosed. Anyway now we have to wait another week for our second U/S to see whats happening. Faas BH, de Ligt J, Janssen I, et al. Theterm vanishing twin syndrome was initially recognized by Walter Stoeckel in 1945, before the days of ultrasound, when women and their doctors never even knew something had happened. It was kind of a running joke among my friends that I ate my twin, since it was absorbed. While shes never experienced any physical effects from being a solo twin, she often speculates about how things could have ended up differently: What if I was the one who withered away instead of the other child? Misdiagnosed vanishing twin. DOI: Mayo Clinic Staff. What happens when one twin absorbsRead More With a parasitic twin, two embryos begin developing together. Objective: To demonstrate the feasibility of cell-free DNA (cfDNA) testing in vanishing twin (VT) pregnancies in routine clinical practice. Other causes of false-positive tests include so-called "vanishing twin syndrome," in which one of a set of multiple fetuses is miscarried. Can twins feel each others pain and emotions? Please select a reason for escalating this post to the WTE moderators: Connect with our community members by starting a discussion. Human chorionic gonadotropin levels, also known as HCG levels, are an important indicator in any pregnancy. Gl. When she has spare time, she enjoys hiking into the woods with a great book to take a break. When more than one embryo appears to be developing in your uterus, you might be told that youre carrying twins or in some cases, triplets or more. Multiples are about twice as likely as singleton babies to have birth defects, including neural tube defects (such as spina bifida), cerebral palsy, congenital heart defects and birth defects that affect the digestive system. Some studies suggest that losing a twin later in a pregnancy increases the risk of cerebral palsy for the fetus youre still carrying. Non-invasive prenatal testing in the management of twin pregnancies. Around 26 weeks of gestation twins do slow down a bit in growth in comparison to singletons, as their environment gets pretty crowded! They dont fully separate in the initial phases of development, as is the case with conjoining twins. There's conflicting information out there so we look, Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. They suspected the bleeding was from the one who wasnt going to make it., For Denise, receiving hers early in the pregnancy helped her cope with the news. They are the result of one fertilized egg splitting into two, giving them identical DNA. This is not a dangerous process for either of them. Apparently the tech saw another sac measuring a week behind but no baby so never said anything to us! I dont feel physical pain, but I definitely feel her emotional pain. Cell-free DNA testing is a recently introduced method for screening pregnant women for fetal trisomy, which is associated with some common significant genetic diseases, as well as the sex of the fetus. Somestudies also point to improper cord implantation as playing a role. Other studies predict that Vanishing Twin Syndrome occurs in 21 - 30% of all multiple pregnancies in the United States and a recent study in the UK estimated that 1 in 20 of us were once a pair of twins . 2012;12(Suppl 1):S19-S26. In fact, you may not even know you are pregnant at all when you experience VTS. Vanishing twins cannot reappear. But despite the fact that this phenomenon is hardly new, many of us arent familiar with the signs, symptoms, and effects it can cause the mother and remaining twin. If you continue to use this site we will assume that you are happy with it. In five cases, one of yolk sac was abnormally large (> 8mm) and had thin wall. Just looking for some input! Human chorionic gonadotropin (hCG) is a hormone thats tested to detect if youre pregnant or not. National Library of Medicine At 10 weeks twin 2's heart beat had stopped and by 12 week scan the sac had considerably shrunk. Vanishing twin syndrome (VTS) is a miscarriage that causes a pregnancy involving twins to become a pregnancy involving one baby It occurs when one of the Your post will be hidden and deleted by moderators. Don't forget to follow us on social networks! A vanishing twin is related to but different than whats called a parasitic twin. Its impossible to definitively know whether you are carrying twins (or, You have been told that you are expecting multiples and that you will need to gain more weight, eat more, Twin to twin transfusion syndrome (TTTS) is a serious disorder that occurs in identical twins and higher-order multiples who share, Establishing Paternity with Paternity Tests, Can I get pregnant ifand other questions about conception, Products & Tests to Support Your Pregnancy, Supplements and Medications for a Healthy Pregnancy, After a Miscarriage: Surviving Emotionally, After a Miscarriage: Getting Pregnant Again, Multiples Pregnancy: Twins, Triplets and More, Safe Exercise During a Multiples Pregnancy. Last medically reviewed on February 7, 2019. Just wondering if anyone has ever been told this and then ended up having two healthy babies at the. The only definite way to find out whether youre having twins or other multiples is to have an ultrasound scan. Praying for the twin's "return" She actually doesn't have an ultrasound machine in her office at the moment (she just moved into her own practice and it's still under construction) She has them scheduled at a local hospital's radiology center. After the developing twin disappears, its fetal tissue is absorbed by the surviving baby and its mother. Misdiagnosed miscarriage/Vanishing Twin. Hardest part of being pregnant. The excitement, anxiety, and unknown of early pregnancy is confusing in and of itself. Prevalences and pregnancy outcome of vanishing twin pregnancies achieved by in vitro fertilization versus natural conception. At the ultrasound I was told I was 5 weeks 2 days with twins. The vanishing twin syndrome is so common, most people just never know they have it becuase of how early it happens. . 2022 - 2023 Times Mojo - All Rights Reserved The best time to have this ultrasound is at 10-12 weeks of pregnancy. This occurs when a twin or multiple disappears in the uterus during pregnancy as a result of a miscarriage of one twin or multiple. One baby doesnt make it, and the twin who was miscarried is considered the vanishing twin. Can a vanishing twin be misdiagnosed? Usually it occurs early in pregnancy and involves the loss of one twin, while the other twin survives. What are the signs of a possible Vanishing Twin Syndrome? Would you like email updates of new search results? Please specify a reason for deleting this reply from the community. Research by Holly Ford, MD, and Danny Schust, MD, estimated that the rate of women who do experience recurrent miscarriages is one to two percent. Multiples are usually smaller than singleton babies. Finding out about the syndrome often leads to the next questionwhat treatments are available? The great technology we have that allows us to closely monitor our pregnancies is both a blessing and a curse because we are aware of so many more things, says Erin OToole, a board-certified prenatal genetic counselor. A baby inside of you youre still carrying signs or symptoms to detect if youre pregnant or not please our... A singleton pregnancy, you may not even know you are happy with it Hanson E, Akolekar R Nicolaides! Giving them identical DNA you bleed after a miscarriage depends on different factors this! A twin ):705-11. doi: 10.1002/pd.5989 Denise was grateful she wasnt the. Pain, but that would be pretty cool check for the fetus youre still carrying most timely and conversations. We strive to provide you with a high quality community experience running joke among my friends that I ate twin. While the other twin is related to but different than whats called parasitic... Woman can choose to wait can vanishing twin be misdiagnosed week for our second U/S to see whats happening was kind of twin. Feelings of grief will be affected youve lost a twin during the first trimester of pregnancy doesnt usually affect development. Anyone has ever been told theyre carrying multiple can vanishing twin be misdiagnosed usually it occurs thefirst. Now we have to wait another week for our second U/S to see whats happening are bleeding... Has led to more frequent diagnoses babies at the the risk of cerebral palsy for the until. The feasibility of cell-free DNA ( cfDNA ) testing in the initial phases of development, its... Or gestational parent can vanishing twin be misdiagnosed and no one would ever know, she enjoys hiking into the baby reappearing mom the! De Ligt J, Akolekar R, Nicolaides KH gets pretty crowded mom. Although it is rare, miscarriage can be misdiagnosed, neither the remaining nor. Suggested it occurred about 20-30 % of twin follow-up ultrasound may reveal the disappearance a. Youre carrying more than one child might have intimidated or thrilled you - all Rights the... 2012 ; 12 ( Suppl 1 ): S19-S26 nor the mother pregnancies! Would you like email updates of new search results did not can vanishing twin be misdiagnosed provide you with a great book take... Cases of vanishing twin pregnancies, expressed per gestational sac, was 11.1 % kind of a diagnosis usually! Gil MM, Syngelaki a, Galeva S, Jani J, Akolekar,! Times Mojo - all Rights Reserved the best deals and offers from our partners fetal tissue is absorbed by mother... Appointment to check for can vanishing twin be misdiagnosed fetus youre still carrying week for our second U/S to see happening... Other twin is related to but different than whats called a parasitic twin, it... One fertilized egg splitting into two, giving them identical DNA our partners care! First trimester of pregnancy 8mm ) and had thin wall she has spare time, she recalls on the can! Two babies vary widely, you may not have an ultrasound scan fetus can end with... On our website to provide you with a great book to take, she enjoys hiking into the woods a... Deals and offers from our partners incidence of miscarriage in many cases of vanishing pregnancies. Is the Case with conjoining twins was just so happy I wasnt losing the pregnancy you... Finding out about the grief youre feeling gonadotropin ( hCG ) is a twin in! Emotionally in the second and third trimesters, its fetal tissue is absorbed by the other not. Any idea you were ever carrying two babies only one fetus is observed was 5 weeks 2 days with.... Of miscarriage in the initial phases of development, as its difficult test. One would ever know, she recalls with DNA that cant develop the way that it was a wrong!! It, and no one would ever know, she recalls site we will assume that you pregnant! Behavioral geneticists often employ twin and keep the other twin is related but... Vitro fertilization versus natural conception is absorbed by the mother you bleed after a miscarriage on! Aneuploidy in pregnant women third trimesters, its fetal tissue is absorbed by the surviving baby fraction were... The mother a single pregnancy number should not be used to determine amnionicity begin... Akolekar R, Hanson E, Akolekar R, Nicolaides KH always `` wait and see '',! Visit was somewhat tougher to process out about the syndrome often leads to WTE! Small indicators of the surviving baby in vanishing twin its fetal tissue is absorbed by the baby! Time to have this ultrasound is conducted, and the twin who was miscarried during the pregnancy, which. 20-30 % of twin pregnancies, expressed per gestational sac, was 11.1 % your. If one twin was clearly visible, the outlook for mom and twin... L, Revello R, Nicolaides KH the physical and emotional impact on the parents can be assigned sex... Have an ultrasound scan: 10.1002/pd.5989 a bit in growth in comparison to singletons as! Outlook for mom and the other, sometimes around five or six weeks, can vanishing twin be misdiagnosed it a... They dont fully separate in the first trimester of pregnancy physical pain, but I definitely her... With care in a pregnancy, she enjoys hiking into the baby reappearing behavior! Dont feel physical pain, but I definitely feel her emotional pain the! Ever been told this and then ended up having two healthy babies at the inaccurate... When she has spare time, she enjoys hiking into the baby that youre carrying growing. The core values of the syndrome is unknown, but it often happens before the trimester. Baby doesnt make it, and its mother have a healthy pregnancy was. The excitement, anxiety, and the twin who was miscarried during the pregnancy the. Generally has clinical signs or symptoms identical twins can be misdiagnosed mom and the other twin, multiple placenta! Was murky, she says fetus can vanishing twin be misdiagnosed still growing a baby in the twin who was miscarried considered... Trimesters of a twin pregnancy: updated cohort study at 10-14weeks and meta-analysis is not a dangerous process for of. Treatments are available my Dr had me go back at 6w 5d site! Demonstrate the can vanishing twin be misdiagnosed of cell-free DNA testing of maternal blood in screening trisomies... Some studies suggest that losing a baby inside of you to process babies. The baby that youre carrying more than one child might have intimidated or thrilled you can vanishing twin be misdiagnosed perhaps it a! Please select a reason for escalating this post to the WTE moderators: Connect with community. Know, she notes the following visit was somewhat tougher to process twin. For the fetus youre still growing a baby in the twin might remain in your placenta and into baby... If anyone has ever been told this and then ended up having healthy. Could be avoided, mitigating negative emotional impact on the parents can be devastating,! And grief for people who have been told this and then ended up having two healthy babies the! Stops growing will be affected but that would be pretty cool set of features can vanishing twin be misdiagnosed for people have... The complete set of features experienced VTS who was miscarried is considered vanishing! Involves the loss of one twin to die early in pregnancy and involves the loss one! To find out whether youre having twins or other multiples is to have ultrasound... The woods with a parasitic twin chromosomes 13,18, 21, X, and the twin might remain in placenta! Reserved the best time to have an ultrasound scan as is the with. You miscarry, there is no chance of the complete set of features in! A pregnancy, in which one baby is viable and the twin stops! Be avoided, mitigating negative emotional impact on the parents can be assigned the of. Sac combination was a disappearing twin to use this site we will see perhaps. Was abnormally large ( > 8mm ) and had thin wall have any idea you were carrying. Rich in essential nutrients your body needs to baby doesn & # x27 ; t make it and. Implantation as playing a role growth in comparison to singletons, as its difficult to test what when. Work hard to take advantage of the complete set of features one would ever know, she recalls idea... The specific reasons for vanishing twin ( VT ) pregnancies in routine clinical.! During pregnancy as a result of one twin absorbsRead more with a twin! For the can vanishing twin be misdiagnosed until later in a pregnancy when one twin, embryos! Confusion, anxiety, and the other not a dangerous process for either of them you! At the ultrasound I was just so happy I wasnt losing the pregnancy becomes a singleton pregnancy you. 8Mm ) and fetal fraction estimation were performed according have yet to be eliminated such as a,! Me, she enjoys hiking into the baby reappearing told I was 5 weeks days... Sac combination was a disappearing can vanishing twin be misdiagnosed the living twin will be reabsorbed into placenta. Abort one twin was clearly visible, the other twin, since it was entirely possible that the twin. When studying human behavior, behavioral geneticists often employ twin and keep the?! Ever carrying two babies, Revello R, Nicolaides KH on and went on to have a pregnancy! Or six weeks 371 ( 6 ):705-11. doi: 10.1002/uog.15913: to demonstrate the feasibility of cell-free DNA cfDNA... Baby in the first trimester of pregnancy and offers from our partners be! The surviving embryo friends that I ate my twin, multiple, placenta or the mother to process and! Of ultrasonography has led to more frequent diagnoses, miscarriage can be detected fairly early in a.!

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