In a rare surgery, malformed fetus removed from inside infant in India

Story by Sumesh Rajan

Mumbai: 28 February 2018

In a rare case of ‘fetus in fetu’, a malformed fetus was removed from the body of its seven-month-old twin sister at the Civil Hospital, Asarwa, Ahmedabad in the western Indian state of Gujarat, on February 19.

Fetus in fetu is a rare condition that has been defined as the presence of one of the twins in the body of the other. It is most frequently located in retroperitoneal (the anatomical space in the abdominal cavity behind the peritoneum) area; however, it has been reported in other locations as well. This is an extremely rare abnormality which only happens about one in per 500,000 births.

 

“In this case, the surgery was tough as the undeveloped fetus was behind the intestine and between both the kidneys,” informed Dr. Rakesh Joshi, Head of the Department of Pediatric Surgery at Civil Hospital, Ahmedabad.

The infant named Prinsa, the first child of Manisha (23) and Motisingh (25) – a farmer from Kavant in Chhota Udaipur in Gujarat, was brought to the Civil Hospital In Ahmedabad after her parents noticed a fast growing lump in her abdomen two months ago.

“The formation is caused by the incomplete separation of twins, which fails to grow and instead becomes an internal part of the healthy twin. It is not a benign condition but as the fetus grows at an alarming rate it starts putting pressure on the organs of the healthy baby,” explained Dr. Joshi.

He added, “In this case, the undeveloped fetus had a normal vertebrae column, brain tissues, head, limb buds and an anal dimple.”

 The surgery, headed by Dr. Joshi, was done by a team of six including three senior anesthetists – Dr. Namrata, Dr. Ramila, and Dr. Asit.

According to the hospital doctors, Prinsa’s mother did not get an antenatal sonography done during her pregnancy. “With various kinds of sonography available during pregnancy, it is not difficult to spot such abnormalities but these people are from a rural area where such facilities are not available,” said Dr. Joshi.

“The parents of the child noticed a lump like structure in the child but ignored it. This happened when the child was five months old. Since the lump was growing at an alarming rate, the parents got it checked in Vadodara and then came to our hospital,” said Dr. Joshi.

“On February 15, the baby was admitted to our hospital. Histopathology examination revealed fetus in fetu, and the surgery was successfully conducted on February 19. She is under observation and is recovering now, and will be discharged in a couple of days. There will be no future complications in the case and she will grow up normally,” said Dr. Joshi.

He said that according to medical literature there are only 200 cases of this condition to have been reported worldwide.

In a similar case in July 2017, a 7 cm half-formed fetus, with a brain and limbs, was found lying behind the stomach of its just twin brother at Mumbai, India.