For the time being of conception, twins start a lifelong relationship that scientists assume may reply a few of life’s profound questions. Whereas twinning is mostly thought-about to be a pure and scientific marvel, mysterious circumstances resulting from accidents of nature might be devastating.
In January 2025, medical doctors on the Buldhana District Ladies’s Hospital in Maharashtra detected a uncommon case of “foetus in foetu” in a pregnant lady. This situation happens when a malformed foetus develops inside one other foetus. The congenital anomaly was detected throughout a daily sonographic evaluation of a 32-year-old pregnant lady.
‘Foetus in foetu’ is a foetus-like mass developed throughout the physique of the opposite foetus in a monozygotic twin being pregnant. Principally, one twin may be very underdeveloped and enwrapped contained in the physique of the opposite twin, a lot in order that the being pregnant is taken into account a singleton being pregnant. The presence of a twin contained in the physique of the opposite twin might go undetected for years. On this case, the situation was found throughout a routine being pregnant scan itself. The girl delivered the child by a C-section supply. Docs carried out a surgical procedure on the new child to take away the undeveloped foetus wrapped within the toddler’s physique. Each the mom and child recovered effectively.
Often known as cryptodidymus, this uncommon congenital dysfunction impacts about one in 500,000 births. Lower than 200 circumstances have been reported worldwide, with about 10 to fifteen circumstances in India.
Why does this situation happen?
The precise reason for this situation isn’t totally understood, nevertheless it’s believed to consequence from an anomaly through the improvement of monozygotic or an identical twins. About 10 to fifteen days after the conception of monozygotic twins, the cell mass of the embryo could also be cut up inconsistently, resulting from which one twin is smaller and incompletely fashioned with the opposite twin totally developed. The smaller twin will get trapped throughout the bigger twin. The trapped twin is taken into account “parasitic,” because it attracts its blood provide and vitamins from the opposite “host” twin. The trapped or “parasitic twin” has some morphologic options of a standard foetus corresponding to an umbilical cord-like construction, a bag of membranes surrounding it, and blood vessel connections to the host twin. It might have a vertebral column, limbs, and some organs however lacks very important organs just like the mind, coronary heart or intestine. Regardless of having “dwelling tissue,” the parasitic twin has no prospects of unbiased existence exterior the host twin.
The presence of the parasitic twin impacts the well being of the host twin, who has to “feed” the previous from the vitamins obtained over a single umbilical wire. As well as, enlargement of the trapped parasitic twin might compress very important organs within the host and trigger discomfort or life-threatening problems.
Typically, the parasitic twin is discovered within the stomach of the host twin. Not often, it might be present in different organs just like the mind or chest. A lot of the circumstances reported have introduced in childhood as an belly mass inflicting intestine obstructions and swelling. X-rays and CT scans have confirmed the presence of foetal buildings like digits, limbs, a backbone, and so forth., within the mass. Therapy is surgical excision of the mass — the parasitic twin — with particular consideration being given to the foetus’ blood provide.
A unbroken thriller
Foetus in foetu is taken into account a thriller of twinning for numerous causes: the precise mechanism of how one twin turns into enclosed throughout the different throughout early embryonic improvement isn’t totally understood. This wants higher perception into early embryologic processes. Whereas some circumstances present well-defined physique buildings, others might solely current as a mass with poorly developed organs, making prognosis difficult. The age of presentation is variable, with some circumstances recognized solely when the host twin was 40 or so. The presentation might differ from seizures, to tumour-like lots, or intestine, or kidney obstructions relying on the place the trapped twin lies.
There’s additionally the data that foetus in foetu perhaps a developmental anomaly quite than a real twin being pregnant, and what’s thought-about a parasitic twin may very well be a teratoma, a tumour with many parts together with bones, pores and skin, hair, and so forth. On this regard, monitoring for potential malignancy is advisable.
(Dr. Deepa Hariharan is a senior neonatologist. nicu_deepa@yahoo.com)
Revealed – February 14, 2025 12:01 am IST
