Fetus Papyraceous in Monochorionic Diamniotic Twins

Abstract

She has seven case studies and five case reports published in international and national journals. She has been awarded FICOG and is presently pursuing advanced course in medical education technology from MCI nodal center, Karamsad. She is a member and resource faculty of medical education technology of CMCH, Bhopal, and has participated in several RBCW workshops. Has a passion for implementing her own innovative methods for teaching students. The author has the experience of being speaker, panelist and moderator at AICOG, state-and local-level conferences. She has presented many research papers, posters at AICOG, state-and local-level conferences and won prize. She has written many fictions, poetries which have got published.

Conservative Management After a Single Fetal Death in a Dichorionic Diamniotic Twin Pregnancy and Fetus Papyraceus: A Case Report

“…The cause of death is generally unknown but it is often associated with chromosomal abnormalities, placental abnormalities such as improper insertion of the umbilical cord, or, in the case of monochorionic diamniotic pregnancies, twin-totwin transfusion syndrome. 8 The cause of death of one of the fetuses in this case report was unknown. However, it is important to discuss one of the relevant comorbidities of the patient: epilepsy, which was treated with phenobarbital (100 mg daily).…”

“…In this instance, patients may be asymptomatic or present with abdominal pain and mild genital bleeding. 2,8,9 However, single fetal death after 14 weeks, and especially after the 20 th week of pregnancy, is associated with adverse effects on the surviving fetus, with a higher risk of prematurity (spontaneous or iatrogenic), restricted intrauterine growth, neurological morbidity for the surviving fetus, pre-eclampsia, haemorrhage, and sepsis. 2,4,5,8,10 The prognosis of the surviving fetus is worse in monochorionic pregnancies, regardless of amnionicity, due to mechanisms that are not yet well understood.…”

“…7 The extrinsic compression of the dead fetus by the remaining fetus can result in the appearance of an entity known as fetus papyraceous, a rare event that occurs in 0.018-0.02% of multifetal pregnancies. 8,9 Herein, the authors report a successful case of conservative management of a dichorionic diamniotic twin pregnancy after a single fetal death in the second trimester of pregnancy.…”

Fetus papyraceous with successful outcome of other twin at term

“…3 The loss of one twin in the first trimester does not appear to affect the development of the surviving twin, but loss of one twin after the mid-trimester may increase the risk of IUGR, cerebral palsy, preterm labour, preeclampsia, haemorrhage, sepsis, consumptive haemorrhage, labour dystocia, and perinatal mortality in the surviving twin. 4 Placental or fetal analysis frequently reveals chromosomal abnormalities. Chromosomal analysis of the surviving twin is generally normal.…”

Fetus Papyraceous in Diamniotic Dichorionic Twins: A Rare Entity

“…Fetus papyraceous or fetus compressus is defined as the intrauterine death of a fetus in early twin pregnancy, with retention of that fetus for up to 10 weeks; thus causing mechanical compression of the little fetus, which will look like a parchment paper due to loss of fluids. 1 It absorbs partially or completely, earning it the moniker "vanishing twin." Due to the absorption of amniotic fluid and the compression of the dead fetus between the living fetus's membranes and the uterine wall, it appears to be dry and papery.…”