Features of labour and delivery

• Birth was traumatic
• Breech birth
• Small for dates
• Placenta unusually large

Physical evidence of the lost twin after delivery

• Additional sacs or cords found
• Fetus papyaceous
• Marks or lesions on the placenta
• Twin stillborn or dies close to birth

In body of survivor

• Dermoid cyst
• Teratoma
• Foetus in foetu
• Sexual organs of opposite sex
• Secondary sexual characteristics of opposite sex
• Cerebral palsy in the survivor
• Birth defects in survivor
• Split organs
• Congenital abnormality

Other associations with twinning

• Left handed
• Ambidextrous
• Chimerism
• Mosaicism

The signs and indications of a twin pregnancy resulting in the birth of one baby

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The mother’s pregnancy

• Mother abnormally large around the waist in the first three months
• First trimester bleeding
• Complete miscarriage but pregnancy continued
• Suspected miscarriage but pregnancy continued
• Attempted abortion but pregnancy continued
• Doctor or nurse suspected twin pregnancy
• Another person suspected twins
• Mother experienced blunt trauma in an accident or assault when pregnant
• Mother experienced infection during pregnancy
• Mother experienced severe trauma during pregnancy
• Mother experienced starvation through illness famine or hyperemesis
• Mother took hyper-ovulation drug (eg. Clomid)
• More that one embryo transplanted after IVF
• Ultrasound evidence of second sac

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