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Fetus papyraceus causing dystocia in a rural setting: a case report

INTRODUCTION: Fetus papyraceus is a rare condition which describes a mummified fetus in a multiple gestation pregnancy in which one fetus dies and becomes flattened between the membranes of the other fetus and uterine wall. We report a case of fetus papyraceus diagnosed during labor as a result of a...

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Autores principales: Matovelo, Dismas, Ndaboine, Edgar
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4549022/
https://www.ncbi.nlm.nih.gov/pubmed/26303514
http://dx.doi.org/10.1186/s13256-015-0666-9
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author Matovelo, Dismas
Ndaboine, Edgar
author_facet Matovelo, Dismas
Ndaboine, Edgar
author_sort Matovelo, Dismas
collection PubMed
description INTRODUCTION: Fetus papyraceus is a rare condition which describes a mummified fetus in a multiple gestation pregnancy in which one fetus dies and becomes flattened between the membranes of the other fetus and uterine wall. We report a case of fetus papyraceus diagnosed during labor as a result of arrested descent. CASE PRESENTATION: A 23-year-old Sukuma woman, gravida 2, para 1 presented to an maternity emergency unit of Sengerema Designated District hospital at a gestation age of 35(+5) weeks as a referral from a rural health center due to arrested descent despite being in active labor for the past 8 hours. On vaginal examination, her cervix was 6cm dilated; fully effaced, presenting part was at station −3. A sharp and solid object-like thing was felt on the right side of her cervix. Due to uncertainty of the presenting part together with arrested descent, a decision was reached to deliver her by caesarean section. A twin gestation was identified during caesarean section: one being a male baby in cephalic presentation, weighing 1.9kg with Apgar score 8 in first minute and 9 in fifth minute with its own normal placenta and membranes. There was another atrophied placenta with calcifications without a cord and with mummified fetal bones on the anterior to the lower segment at the level of the internal orifice of the uterus. The atrophied placenta and mummified fetal bones weighed 200gms. One unit of blood was transfused intraoperatively due to severe anemia prior to surgery. Both the mother and the baby were discharged home in good condition. CONCLUSIONS: The primary concern for fetus papyraceus is its effect on the surviving fetus and on the mother. To avoid possible complications, the intrauterine diagnosis of fetus papyraceus by serial ultrasound examinations and routine placental examination to search for fetus papyraceus is mandatory.
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spelling pubmed-45490222015-08-26 Fetus papyraceus causing dystocia in a rural setting: a case report Matovelo, Dismas Ndaboine, Edgar J Med Case Rep Case Report INTRODUCTION: Fetus papyraceus is a rare condition which describes a mummified fetus in a multiple gestation pregnancy in which one fetus dies and becomes flattened between the membranes of the other fetus and uterine wall. We report a case of fetus papyraceus diagnosed during labor as a result of arrested descent. CASE PRESENTATION: A 23-year-old Sukuma woman, gravida 2, para 1 presented to an maternity emergency unit of Sengerema Designated District hospital at a gestation age of 35(+5) weeks as a referral from a rural health center due to arrested descent despite being in active labor for the past 8 hours. On vaginal examination, her cervix was 6cm dilated; fully effaced, presenting part was at station −3. A sharp and solid object-like thing was felt on the right side of her cervix. Due to uncertainty of the presenting part together with arrested descent, a decision was reached to deliver her by caesarean section. A twin gestation was identified during caesarean section: one being a male baby in cephalic presentation, weighing 1.9kg with Apgar score 8 in first minute and 9 in fifth minute with its own normal placenta and membranes. There was another atrophied placenta with calcifications without a cord and with mummified fetal bones on the anterior to the lower segment at the level of the internal orifice of the uterus. The atrophied placenta and mummified fetal bones weighed 200gms. One unit of blood was transfused intraoperatively due to severe anemia prior to surgery. Both the mother and the baby were discharged home in good condition. CONCLUSIONS: The primary concern for fetus papyraceus is its effect on the surviving fetus and on the mother. To avoid possible complications, the intrauterine diagnosis of fetus papyraceus by serial ultrasound examinations and routine placental examination to search for fetus papyraceus is mandatory. BioMed Central 2015-08-25 /pmc/articles/PMC4549022/ /pubmed/26303514 http://dx.doi.org/10.1186/s13256-015-0666-9 Text en © Matovelo and Ndaboine. 2015 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/ (http://creativecommons.org/licenses/by/4.0) ), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Case Report
Matovelo, Dismas
Ndaboine, Edgar
Fetus papyraceus causing dystocia in a rural setting: a case report
title Fetus papyraceus causing dystocia in a rural setting: a case report
title_full Fetus papyraceus causing dystocia in a rural setting: a case report
title_fullStr Fetus papyraceus causing dystocia in a rural setting: a case report
title_full_unstemmed Fetus papyraceus causing dystocia in a rural setting: a case report
title_short Fetus papyraceus causing dystocia in a rural setting: a case report
title_sort fetus papyraceus causing dystocia in a rural setting: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4549022/
https://www.ncbi.nlm.nih.gov/pubmed/26303514
http://dx.doi.org/10.1186/s13256-015-0666-9
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