Pregnancies rarely go according to plan. Sadly, even with all of the advanced medical technology available nowadays, miscarriages and stillbirths continue to happen all too frequently. Pregnancies where twins or triplets, etc. are expected bring with them the risk of fetus papyraceous: the death and mummification of one or more of the fetuses.
Fetus papyraceous occurs when a fetus dies in utero. During the first trimester, fetus death would trigger a natural abortion and would be expelled from the body. With fetus papyraceous, this miscarriage happens later in the pregnancy when the bones and other organic material are no longer able to be absorbed by the body. Depending on the length of time the deceased fetus is left within the womb, it will begin to decay and possibly even mummify.
Effects on Surviving Twin
Fetus papyraceous is generally found in the case of multiple-birth pregnancies and is therefore also called "Vanishing Twin Syndrome." The effects this death has on the surviving fetus(es) depends on how late in the pregnancy the death occurred, the amount of time that passes between the death and its discovery, and whether the twins shared the same placenta. If the death happens during the second half of the pregnancy, there's an increased risk of cerebral palsy in the surviving twin.
Effects on the Birth
Preterm delivery is one of the greatest risks with fetus papyraceous. With the decay of the deceased fetus, there's a risk of infection should the placenta become compromised. Depending on where the fetus is located within the womb, it can also affect the birth of the surviving twin. A vaginal birth may be impossible if the fetus papyraceous is low-lying, which would make the only alternative a cesarean section.
Studies so far have shown that it is not linked with the race or sex of the fetus. The age of the mother is something that may play a role. Women who conceive after the age of 30 have a greater risk of complications and genetic birth defects, which could lead to fetus papyraceous. Two possible causes are pregnancy-induced hypertension and preeclampsia.
Management of Pregnancy
It is possible that doctors may not discover the death of a fetus in a multiple birth until delivery. Its placement within the womb might make it invisible to ultrasound and therefore impossible to detect. If it is detected within the second trimester it becomes a balancing act between ensuring the survival of the living twin against preterm birth and possible physical side effects. Since the cause of the deceased twin's death is unknown during gestation, delivering the surviving twin as early and safely as possible is essential.