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Dr Jagdish S Malpani M.D., D.G.O.,F.C.P.S. Nashik Ob/Gy Society

FOETUS PAPYRACEOUS (A rare case) presented by. Dr Jagdish S Malpani M.D., D.G.O.,F.C.P.S. Nashik Ob/Gy Society. INTRODUCTION. Foetus papyraceous is a rare complication of Twin pregnancy in which death of one foetus occurs at mid-pregnancy, but the pregnancy continues thereafter. .

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Dr Jagdish S Malpani M.D., D.G.O.,F.C.P.S. Nashik Ob/Gy Society

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  1. FOETUS PAPYRACEOUS (A rare case) presented by Dr Jagdish S Malpani M.D., D.G.O.,F.C.P.S. Nashik Ob/Gy Society Monsoon Masti

  2. INTRODUCTION Foetus papyraceous is a rare complication of Twin pregnancy in which death of one foetus occurs at mid-pregnancy, but the pregnancy continues thereafter. Monsoon Masti

  3. CASE HISTORY • Renuka 20yr Old Primigravida • C/O 8 mths amenorrhoea with preterm labour pains • Referred from Peripheral Hospital to JDC Bytco Municipal Hospital for ? Compound Presentation. • P 88/mt BP 130/80 Pallor Nil Oedema Nil CVS/RS NAD Rest NAD • PA- Ut 34 wks Vx Eng ROT FHS 126/mt Regular • PV- Cx 2-3 Cm dil 40-50% Eff., PP Vx stn –1, Small limb like structures felt in front of Vx, which were thin, irregular. • INVESTIGATIONS • Routine investigations were normal. • Coagulation profile was normal. • USG done 20 days ago showed Single iu pregnancy with AGA 32wks, in Vx with mild oligoamnios Monsoon Masti

  4. X-RAY Macerated Vertex Humerus Femur Spine Monsoon Masti

  5. X- RAY Vertex Humerus Femur Monsoon Masti

  6. MANAGEMENT • Low dose Pitocin was administered. • Inj. Drotin, Inj. Tramadol was given • Pt delivered vaginally with mummified Foetus Papyraceous delivering first with its macerated cord and placenta and normal Co-twin delivering by vertex Male 2.250 Kg, • 3 rd stage of labour was uneventful. • Post partum period was uneventful • Pt was discharged on 5th Day. Monsoon Masti

  7. NORMAL CO-TWIN & FOETUS PAPYRACEOUS Monsoon Masti

  8. FOETUS PAPYRACEOUS Monsoon Masti

  9. DISCUSSION • Incidence- 1:184 of Twin pregnancies (.54%) • The amniotic fluid and sometimes the placental tissue may be reabsorbed, and the dead foetus is compressed between the amniotic sac of the co-twin and the uterine wall. • Degree of compression depends upon the interval between death of the foetus and delivery. Monsoon Masti

  10. REFERENCES • Livnat E J, Burd L, Cadken A, Keh P et al, Foetus Papyraceous in Twin Pregnancy; Obstetrics & Gynaecology 1978; 51 Suppl. 418-458 • Mills (1949), J.Obstetric &Gynaecology of British Empire, 56,619 Monsoon Masti

  11. Thank you! Monsoon Masti

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