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October 16, 1967

Fetus Papyraceus With Intrauterine Sibling Death

Author Affiliations

Brooklyn, NY

JAMA. 1967;202(3):247. doi:10.1001/jama.1967.03130160121043

To the Editor:—  When one sibling of a multiple pregnancy dies during early gestation, the dead fetus is retained in utero along with its viable sibling, and it may not interfere with its sibling's growth and survival. An uneventful pregnancy is said to be the rule.1 An exception is reported in which a fetus papyraceus, or dead twin, was associated with the later intrauterine death of its sibling. The diagnosis was made from antepartum roentgenograms.

Report of a Cas:e:—  The 27-year-old patient was para 0, gravida 1, Rh +, and healthy. Her expected date of delivery was June 24. Her membranes ruptured on April 7. A fetal heart was heard on April 23. Labor began on May 11, but no fetal heart was heard. Roentgenographic study done that day revealed a twin pregnancy one of which was a fetus papyraceus: the other was a recently dead twin, death having taken place between April 23 and May 11. The roentgenographic features are described in the legends accompanying Fig 1 and 2. The next morning there was a spontaneous delivery of dead twins. The first was a macerated fetus papyraceus. Its stillborn twin followed as a breech. There were no complications.