A Rare Sequela of Twin Demise: Fetus Papyraceous

Abstract

Fetus papyraceous is a rare condition where there is intrauterine fetal compression of one of the fetuses of a twin pregnancy, which may cause complete resorption or result in a parchment paper-like appearance of that fetus. We report one such case of twin pregnancy in a 23-year-old primigravida with 36 weeks of amenorrhoea. Ultrasonography done during her antenatal visits revealed a twin pregnancy with one dead fetus. She delivered one healthy baby, the placenta, and another pale white membranous tissue with firm areas. Histopathological examination of multiple tissue sections of the specimen revealed placental tissue characterised by firm consistency, greyish discolouration, and areas of calcification. Fragments of an umbilical cord were also observed. Additionally, a markedly compressed fetus was identified, exhibiting significant limb deformities, confirming the diagnosis of fetus papyraceous. The basic concern of a fetus papyraceous is its detrimental effects on the mother and the surviving fetus. To avoid possible complications, intrauterine diagnosis of a fetus papyraceous by serial ultrasound examinations and routine placental examination post-delivery should be keenly followed. The pregnancy was diagnosed as a dichorionic diamniotic twin gestation with intrauterine demise of one fetus during the second trimester.

Keywords: Fetus papyraceous, Twin pregnancy, Vanishing twin syndrome, Intrauterine fetal demise, Histopathology, Placenta