STONE BABIES (Lithopedia)

STONE BABIES (Lithopedia)


This is a rare medical phenomenon, as at date, Only about 300 cases have been reported or documented. It Was First described by Dr Albucasis (an Arab Muslim physician and surgeon who was the first physician to describe an ectopic pregnancy, and the first physician to identify the hereditary nature of haemophilia).

Lithopedion; a fetus that has died during an ectopic pregnancy (pregnancy outside the Uterus,in this case mostly abdominal pregnancy) and has become calcified, ossified or hardened. It may remain undiagnosed for decades. Also called calcified fetus, lithopedium, ostembryon, osteopedion. Lithopedia; plural.

Lithopedion ( Picture Credit: citizenpost. )

Tends to occur in abdominal pregnancies as opposed to intrauterine pregnancies, even though it is possible for the fetus to remain within the uterus.. A tubal pregnancy can result where the fetus grows within the fallopian tube and rarely the fertilized egg will escape the end of the fallopian tube and settle within the abdomen.
Sometimes the blood supply is established and the child can grow within the abdomen, rarely to term but it can grow. It would take 12 weeks or more for the fetus to reach a size that would be easily visible.

About 1.5 and 1.8% of abdominal pregnancies develop into lithopedia.

Here,the tissues of the dead fetus are too large to be absorbed by the body, so they are walled off as foreign bodies with fibrous tissue and this most often Calcify which is where the term stone baby comes from.

The development of lithopedion happens under certain conditions:
(1) extra-uterine pregnancy;
(2) fetal death after 3 months of pregnancy;
(3) the egg must be sterile;
(4) there cannot be any early diagnosis;
(5) local conditions must exist for calcium precipitation (deposit)

Most times it occurs without symptoms (Asymptomatic) and is discovered incidentally following an Abdominal X-ray taken for some other reason, as the only symptom may be the feeling of discomfort, sensation of a mass or fullness in her abdomen.

Here the woman could have normal Menstruation, and could even become pregnant again since the uterus, ovaries, and fallopian tubes would be normal and would continue to function normally.

However, if the fetus remained within the uterus, this could interfere with future pregnancies, though not always.
It would be very similar to a woman who had large fibroids, which are muscular masses that develop with in the muscular wall of the uterus and often cause pain and abnormal bleeding. Sometimes normal pregnancies occur despite these.

Some associated complications have been reported after a long asymptomatic evolution: urinary bladder and rectum perforation; extrusion of fetal parts through the abdomen wall, rectum and vagina; intestinal obstruction (due to collision of fetal parts with the intestine or adherence), abscess formation and volvulus.

Treatment is by surgical extirpation/removal.


NOTES;

1. Costa SD, Presley J, Bastert G. Advanced abdominal pregnancy. Obstet Gynecol Surv 1991;46:515-25.

2.  Frayer CA, Hibbert ML. Abdominal pregnancy in a 67-year-old woman undetected for 37 years: a case report. J Reprod Med 1999;44:633-5. 

3.  Irick MB, Kitsos CN, O'Leary JA. Therapeutic aspects in the management of a lithopedion. Am Surg 1970;36:232-4.

4.  Mishra JM, Behera TK, Panda BK, Sarangi K; Behera; Panda; Sarangi (September 2007). "Twin lithopaedions: a rare entity". Singapore Medical Journal 48 (9): 866–8. PMID 17728971.

5.  Mosby's Medical Dictionary, 8th edition. © 2009, Elsevier.

6.  Passini, Renato; Knobel, Roxana; Parpinelli, Mary Ângela; Pereira, Belmiro Gonçalves; Amaral, Eliana; de Castro Surita, Fernanda Garanhani; de Araújo Lett, Caio Rogério (November 2000). "Calcified abdominal pregnancy with eighteen years of evolution: case report". São Paulo Medical Journal 118 (6): 192–4.

7.  Spiritos NM, Eisenkop SM, Mishell DR. Lithokelyphos: a case report and literature review. J Reprod Med 1987;32:43-6.