Fetus Papyraceus

Causes and risk factors

The exact cause is not known. It is evident most commonly in the first trimester. However, it can occur in 2^nd trimester or can be diagnosed later.

Clinical presentation

One fetus dies in event of a multiple pregnancy. It is evident in first trimester of pregnancy. It may be associated with a modest amount of vaginal bleeding. During delivery of the viable fetus, this mummified fetus is also expelled out. The fetus appears dried, parchment like, and atrophied. The other fetus usually is healthy and viable. Following delivery, the placenta will frequently show a whitish plaque on the membranes representing the remnant of the other gestational sac.

Investigations

Medical history by the patient and clinical examination by the doctor helps in diagnosis. USG can reveal the condition during ANC checkup.

Treatment

Well-being and growth of the remaining viable fetus must be assured during ANC. Maternal reassurance should be offered as the prognosis for the surviving twin is excellent when fetus papyraceus occurs in the first trimester. Parents will perceive the situation as the loss of a child and perinatal grief counseling is helpful in such conditions.

Complications

Fetus papyraceus is itself a complication of twin pregnancy. However, in this condition complications like threatened abortion of second fetus, heavy vaginal bleeding can occur. Prematurity, low birth weight, skin necrosis, cutis aplasia, cerebral palsy, preterm deliveries are some of the other complications in the surviving twin.

When to Contact a Doctor  

One must consult a doctor if there is per vaginal bleeding during first trimester of pregnancy.

Facts and figures

Between 20% to 50% of multiple gestations identified by ultrasound in early pregnancy are lost either as a spontaneous abortion of all fetuses or by the spontaneous loss and reabsorption of at least one of the multiples.

Systems involved

Female reproductive system

Organs involved

Uterus