A meta-analysis of 136 Q fever pregnancies, including 4 new cases and 7 population-based serological studies, revealed significant increases in fetal death and malformation after Q fever during pregnancy. This poor obstetric outcome is prevented by antibiotic treatment.
Correspondence theory remains speculative as the animal studies have shown no evidence of strings or bands as the cause of the limb deficiency. If the vascular compromise occurred at the time of premature rupture of the membranes there would be adequate time for healing of lesions and resorption of amputations. Healing in the fetus is particularly fast and relatively non-scarring.7 It is likely that this child's limb defects were related to amnion rupture, and are not associated with Van der Woude syndrome.
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