Fetus papyraceous: a rare cause for obstruction to spontaneous placental expulsion.
ABSTRACT Fetus papyraceous is a mummified compressed fetus occurring in association with a viable twin. Incidence of this rare condition is 1 in 12,500 cases of twins. We report a case of fetus papyraceous which caused obstruction to spontaneous expulsion of placenta. Antenatal diagnosis by ultrasound examination is not always possible. Careful exploration of placenta after delivery is recommended. Diagnosis of this condition helps in evaluation of risk to surviving fetus as well as registration and documentation of this rare condition.
- Australian and New Zealand Journal of Obstetrics and Gynaecology 09/1997; 37(3):360-1. · 1.30 Impact Factor
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ABSTRACT: Maternal serum alpha-fetoprotein (AFP) was measured during the second trimester in 219 twin pregnancies uncomplicated by neural-tube defects (NTD) and in 11 twin pregnancies discordant for NTD. Serum AFP levels were recorded in multiples of the median value (MOM) calculated from normal singleton pregnancies. Of the twin pregnancies uncomplicated by NTD 49% had AFP levels less than 2.5 MOM, 7.8% had levels greater than 5 MOM and 59% of these were associated with either abortion, stillbirth or fetus papyraceous. In twin pregnancies with serum AFP levels less than 5 MOM and unsuccessful outcome was noted in only 4% (chi 2, P less than 0.05). There was a significant negative correlation between serum AFP levels and combined birthweights (r = 0.954). All 11 pregnancies discordant for NTD had serum AFP values greater than 5 MOM and this level appears to be a suitable cut-off point above which there should be further diagnostic investigations and monitoring of fetal well-being.British Journal of Obstetrics and Gynaecology 11/1982; 89(10):817-20.
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ABSTRACT: Dizygotic compared with monozygotic conceptions are at decreased risk of fetal and infant death and serious morbidity in surviving infants. Different sex twin maternities must be dizygotic but miscoding and incorrect registration of sex and number of fetuses may lead to an incorrect assignment of zygosity. The aim of the study was to validate the coding and registration of number and sex of births in multiple pregnancies. Fetal and infant death registrations from all multiple maternities in England and Wales 1993-1998 were examined. There were 51,792 twin, 1627 triplet and 51 higher order multiple maternities that were registered. Among these there were 1926 fetal deaths, 58 of which were registered as being of indeterminate sex but were coded as male in 56 and female in 2 cases. A fetus papyraceous was registered as male in 19 and as female in 19 cases. Other fetal deaths weighing >/= 100g, with no mention of papyraceous on the death certificate, nevertheless, likely to be of indeterminate sex, were registered as male in 26 and as female in 23 cases. In 13 maternities, the number of infants registered at birth was less than the number mentioned on the registration certificate. It cannot be assumed that multiple births of different registered sex are dizygotic. As surviving infants from a monozygotic multiple birth are at much greater risk of infant death and serious morbidity than dizygotic multiple births, incorrect assignment of sex has important implications for parental counselling and may have medico-legal relevance when attributing negligence as the cause of morbidity in a survivor from a multiple pregnancy.Twin Research 09/2002; 5(4):270-2.