Fetus papyraceous: a rare clinical image

Cherukuri Srinidhi, Shubhada Jajoo

PAMJ. 2023; 44:28. Published 13 Jan 2023 | doi:10.11604/pamj.2023.44.28.38689

Fetus papyraceous is characterized by the intrauterine fetal demise of a twin occurring early in pregnancy, which is then compressed between membranes and the uterine wall. After a while, the fetus becomes mummified and resembles parchment paper. It is a rare complication with an incidence of 1 in 12,000, mostly among twin pregnancies. Predisposing factors may include: multiple pregnancies, use of assisted reproductive techniques, certain intrauterine conditions like membranous cord insertion. Insufficiency of the placenta or twin-to-twin transfusion syndrome. A 26-year-old unbooked para 2 living 1 with 39 weeks 6 days of gestation with previous vaginal delivery came to a casualty with complaints of lower abdomen pain. Blood investigations and term ultrasound were found to be normal. The patient´s vitally stable. On examination, per abdomen, adequate contractions with a cephalic presentation, fetal heart rate of 150 beats/min present. Per vaginal examination, the cervix is fully dilated and effaced, and membranes present with the adequate pelvis. After spontaneous rupture of membranes, delivered a live term baby with a 2.6 kg birth weight, the baby cried immediately after birth. On examination of the placenta and membranes, there was an incidental finding of a hard, paper-like flattened structure: a shrunken dead fetus-fetus papyraceous. Differential diagnosis of this condition depends on the time of diagnosis antenatal -vanishing twin syndrome in the first trimester, fetus papyraceous in the second trimester, macerated twin in the third trimester.
Corresponding author
Cherukuri Srinidhi, Department of Obstetrics and Gynaecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Sawangi, Wardha, Maharashtra, India (srinidhicherukuri30@gmail.com)

The Pan African Medical Journal (ISSN: 1937-8688) is a subsidiary of the Pan African Medical Journal. The contents of this journal is intended exclusively for professionals in the medical, paramedical and public health and other health sectors.

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