P Yamini Shoba Vani

Abstract

Introduction: In multiple gestations, Fetus papyraceous is a rare obstetric complication, the occurrence of which in twin cases is 1 in 12,500. It may be associated with elevated maternal and foetal complications, including death caused by disseminated intravascular coagulation and organ damage. Objective : To record a case of uniovular twin pregnancy in the early third trimester with one twin foetus papyraceous, and pregnancy continued until term with a good outcome of co-twin survival. Materials and Methods: A 25-year-old Gravida 2, Para 1, Living 1 woman with a previous usual vaginal delivery and twin pregnancy with Fetus papyraceous was referred to our hospital at 39 weeks for healthy institutional delivery. Results : she was admitted and induction of labour done with stripping of membrance and watched the progression of labour along with strict maternal and fetal monitoring. She was monitored by serial ultrasounds with doppler, coagulation profile throughout the pregnancy once the fetus papyraceous was diagnosed which was showing with in normal limits. She delivered vaginally of an alive healthy male baby of birth weight 2.5kg with APGAR score- at 1min-8 and at 5min-10. Conclusion : Routine ultrasound testing with improved training and the use of modern ultrasound machines with good resolution are needed for the detection of multiple gestations. This would allow for early detection of papyraceous foetuses during pregnancy, potentially avoiding obstetric complications and lowering the risk of mortality.   Keywords: Fetus papyraceous, Uniovular twins, Third trimester, obstetric complications, Maternal coagulopathy, Twin pregnancy

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