India at present has 145,779 active coronavirus disease (COVID) cases and 8884 deaths. Being the largest tertiary care health facility under Delhi Government, our center was designated as a 2000 bedded dedicated COVID hospital. In addition to establishing areas for COVID management, COVID Obstetrics and Gynecology area requires a dedicated set up for delivering women, an operating room, and a neonatal care unit. A phased evacuation plan begins by curtailing non-emergency services and postponing elective surgeries, this process may take longer for obstetrics than other specialties on account of labor and postnatal care. The percentage reduction in the number of elective obstetric and gynecological surgeries was 73% and further fell by 98% (n = 4; category C, D) over a period of 1 month of the evacuation phase, whereas the reduction in emergency cases was only 15% (n = 200) in the beginning and fell to 89%. During the surge phase of COVID, we were able to increase the inpatient surge capacity by 8% (n = 100) as the bed occupancy increased exponentially from 30% to 88%. The start of evacuation of the facility until the endpoint of the surge marks the most dynamic phase of establishing a COVID facility during a pandemic. Pre-event planning for surge capacity at the inception of such pandemics should be based on the local and regional policies which depend on the competing demands of resources to maintain sustainability. These logistical demands are dynamic and vary as the pandemic progresses through its phases.

Fetus papyraceous or compressus is the mummified fetus associated with multiple gestation, where one fetus dies in early second trimester, flattened, mummified and compressed between the membranes of the living fetus and the uterine wall. It is more common in monozygotic twins but may occur in dizygotic variety. However, the maternal and fetal complications in affected cases can be severe. We present a case that was diagnosed as dichorionic diamniotic twin gestation in early pregnancy which subsequently resulted in the fetal demise of one twin in second trimester leading to fetus papyraceus, but careful maternal and fetal monitoring leads to successful healthy outcome of mother and surviving fetus.

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