case-312-fetus-hyperextension
Female 33yo with cutaneous allergy from age of 20, now in 3rd
pregnancy. 2 first girls are normal and no abnormal family history. She has
been treated allergy while was in 12 weeks of gestation [medrol, cefixin,
antihistamine) for one month and changing to Prednisone pommade.
She was recorded the 3rd pregnancy with 2 OB ultrasound examinations at
12 weeks and 18 weeks: Fetus with normal
attitude, heart rate 158b/min, nuchal translucency NT=1.1mm, normal fetal vertebral
column.
But the 3rd OB ultrasound examination, in 23th week, detected
a micrognathia, abnormal curved attitude of vertebral column, hyperextension,
which appeared in days of follow-up. 2
small lungs in small thorax, a few movements of 2 upper and lower limbs and
fingers in extension time by time in uterus.
But other viscera of fetus were
normal.
MRI detected loss of septum pellucidum.
The parturient was sent to HV hospital for a prenatal care, and an amniotic fluid analysis was done . FISH test showed no abnormal chromosome of 13th, 18th, 21th , X and Y, and karyotype result in 4 weeks next. In one week follow-up in hospital, with many sonologists, fetal attitude no change which made thorax more compressed, small stomach and polyhydramnios due to fetus cannot swallow.
Because of nothing change for one week, the poor pregnancy had to be end.
DISCUSSION
Fetus in 23 weeks with
malformation= abnormal hyperextention of vertebral column and four limbs and
micrognathia, no septum pellucidum. FISH
test showed normal 13, 18, 21, X , Y chromosomes.
(Double test and Triple test not yet performed).
In birth, micrognathia, fingers in
gripping, curved vertebral column looked like abnormal 18th chromosome.
Few in literature of abnormal
curved vertebral column of fetus, there was 2 papers but the vertebral column changes normal at
birth without malformation, and babies remain well.
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