P27.10: Antenatal detection of fetal CNS functional impairment using five different behavioral patterns on ultrasound study; Two case reports

Abstract

Poster abstracts superior vena cava with normal size of inferior vena cava, and abnormal intracranial structure. In addition, color US showed many dilated vessels in the intracranial supratentorial lesion. MR imaging/angiography revealed the huge space-occupying lesion in the posterior half of supratentorium, connected with the feeder vessels originated from bilateral middle dural arteries. These findings were compatible with DSM, and we had an expectant managemet until term. However, at 37w6d, just the day before the C/S had been planned, the fetus showed non-reassurring heart rate patterns, and emergent C-section was performed. A 2.790 gr baby girl was delivered at Apgar 1(1 min), 1(5 min), and in spite of intensive resuscitation, the baby died on the same day due to the cardiac failure. In case of congenital cardiomegaly, we always have to take it into consideration that extracardiac lesion might be involved. P27.08 Patients and Methods:A 28-year-old pregnant female was referred at 21 weeks' gestation for a routine prenatal ultrasound. Fetal monitoring was made by ultrasound scans for fetal growth, congenital malformations, and amniotic fluid volume. We also collected information about family medical history. Amniotic fluid samples were taken to perform prenatal cytogenetic diagnosis. Results: Ultrasound examination revealed a single fetus with an abnormal fetal craniofacial and limbs development and oligohydramnios. Craniofacial abnormalities as a sonographic marker suggested the possibility of a chromosomal anomaly. Multiple anomalies were detected, including craniofacial malformations and skeletal malformations. The head shape was markedly abnormal with bulging of the frontal areas and narrowing of the skull at the level of the coronal suture. Karyotype indicated a normal cytogenetic female: 46, XX. There was no family history of congenital anomalies. The couple chose to terminate the pregnancy. The family accepted autopsy. Autopsy findings confirmed the ultrasound diagnosis. Conclusions: The case was sporadic. Spontaneous mutation could be the cause of the case. The complex pattern of fetal anomalies identified and described suggested the possibility of CS. As the gene defect for Carpenter syndrome is unknown, the diagnosis of this condition remains a clinical one. The discovery of single or multiple fetal malformations requires not only complete echo graphic assessment, but also detailed post-abortum examination to allow optimal use of diagnostic aid programmes. Department of Obstetrics and Gynecology, Inje University Ilsanpaik Hospital, Gyeonggi, Republic of KoreaA 34-year-old woman, G5P1 with five weeks of gestation at Feb., 2007, had been taken warfarin since 1993 because of prosthetic mitral valve replacement. Instead of warfarin, she took heparin 8.500 IU/mL subcutaneously twice a day from 6 weeks to 14 weeks of gestation and she took warfarin 7.5 mg per day from 15 weeks of gestation. After that the warfarin regimen was changed to 5 mg per day. During the pregnancy, the INR was maintained between...

<p>Current Perspectives of Prenatal Sonographic Diagnosis and Clinical Management Challenges of Nuchal Cord(s)</p>

“…86 Similarly, we followed a patient with a persistent quadruple nuchal cord throughout the third trimester (Figure 4). 87 Repeat sonographic evaluations at 2-week intervals demonstrated gradual continued decelerating fetal growth. Detailed work-up for fetal growth restriction was negative.…”

“…Intrapartum nonreassuring fetal heart rate necessitated Cesarean delivery of a female infant weighing 2350 grams (<3rd centile for gestational age), with a tight triple nuchal cord. 87…”