Registering a fetus papyraceus

BMJ 1997; 314 doi: https://doi.org/10.1136/bmj.314.7078.441a (Published 08 February 1997) Cite this as: BMJ 1997;314:441

Registration is important for research into cerebral palsy

  1. P O D Pharoah, Professor of public healtha,
  2. R W I Cooke, Professor of child healtha
  1. a University of Liverpool, Liverpool L69 3BX
  2. b Luton and Dunstable Hospital NHS Trust, Luton LU4 0DZ

    Editor–R F Heys questions the need to register a fetus papyraceus as a stillbirth when the cotwin survives, pointing out the distress it causes to the parents.1 We believe, however, that limiting the registration of stillbirths to those weighing ≥500g, as recommended by the World Health Organisation, would be a retrograde step.

    It is well recognised that, in a twin pregnancy, if one twin dies in utero the cotwin has a high risk of cerebral palsy, particularly if the twins were monochorionic. In two population based series the risk of cerebral palsy in a surviving twin when the cotwin died in utero was about 1 in 10.2 3

    The Mersey cerebral palsy register has details of 18 twin pregnancies in which one twin was recorded as dying in utero in …

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