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ARTICLE |

Rule out twin pregnancy in first-trimester bleeding

JAMA. 1979;242(14):1457. doi:10.1001/jama.1979.03300140005002.
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ABSTRACT

Maternal bleeding during the first trimester of pregnancy usually is interpreted as a sign of spontaneous abortion and is followed by dilation and curettage (D &C). In most instances, this procedure is innocuous.

However, two radiologists have called attention to the fact that, in a small number of cases, the dying or dead fetus may be one of twins—the so-called "blighted twin"—and the surviving fetus would be lost during the D&C. To prevent inadvertent abortion of this second fetus, who has a good chance of term delivery, they suggest routine ultrasound examination for women with first-trimester bleeding before surgical procedures are carried out.

Writing in the July 1979 issue of Radiology, Harris Finberg, MD, radiologist at Peter Bent Brigham Hospital and at Boston Hospital for Women, and Jason Birnholz, MD, director of clinical ultrasound at the former hospital and radiologist-in-chief at the latter, present 22 cases in which a blighted

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