1/7. Sirenomelia. Pathological features, antenatal ultrasonographic clues, and a review of current embryogenic theories.We aimed to discuss the prenatal diagnosis and pathological features of sirenomelia, and to review current embryogenic theories. We observed two sirenomelic fetuses that were at the 19th and 16th gestational week respectively. In the former, transvaginal ultrasound revealed severe oligohydramnios and internal abortion, whereas bilateral renal agenesis, absence of a normally tapered lumbosacral spine, and a single, dysmorphic lower limb were detected in the latter. In both cases, x-rays and autoptic examination allowed categorization on the basis of the skeletal deformity. Subtotal sacrococcygeal agenesis was present in both cases. Agenesis of the urinary apparatus and external genitalia and anorectal atresia were also found. classification of sirenomelia separately from caudal regression syndrome is still debated. Recent advances in the understanding of axial mesoderm patterning during early embryonic development suggest that sirenomelia represents the most severe end of the caudal regression spectrum. Third-trimester ultrasonographic diagnosis is usually impaired by severe oligohydramnios related to bilateral renal agenesis, whereas during the early second trimester the amount of amniotic fluid may be sufficient to allow diagnosis. Early antenatal sonographic diagnosis is important in view of the dismal prognosis, and allows for earlier, less traumatic termination of pregnancy.- - - - - - - - - - ranking = 1keywords = abortion (Clic here for more details about this article) |
2/7. Laryngeal atresia presenting as fetal ascites, olygohydramnios and lung appearance mimicking cystic adenomatoid malformation in a 25-week-old fetus with fraser syndrome.We describe a 25-week-old female fetus of consanguineous parents with ultrasonographic findings of increased echogenicity of lungs mimicking CAM (cystic adenomatoid malformation) type III, olygohydramnios and fetal ascites. A therapeutic abortion was performed and unilateral cryptophthalmos, laryngeal atresia and bilateral syndactyly of the hands and feet were observed at post-mortem. These findings confirmed the diagnosis of fraser syndrome after abortion.- - - - - - - - - - ranking = 2keywords = abortion (Clic here for more details about this article) |
3/7. First-trimester diagnosis of sirenomelia. A case report.We report a case of sirenomelia diagnosed at 13 gestational weeks. This rare malformation sequence is characterized by fusion and rotation of the lower limbs to various degrees and anorectal atresia, usually associated with absence of bladder and agenesis or dysgenesis of the kidneys. Diagnosis is commonly made later in the second trimester of pregnancy with oligohydramnios as the alerting sign. survival is extremely rare, and only possible in the absence of bilateral renal agenesis. In view of the dismal prognosis, early diagnosis allows for earlier and less traumatic therapeutic abortion.- - - - - - - - - - ranking = 1keywords = abortion (Clic here for more details about this article) |
4/7. safety of surgical intervention during the second trimester of pregnancy. A case report.Surgical and anesthetic interventions during pregnancy are not hazard free. While an increase in fetal resorption and the abortion rate during the first trimester is well documented, a second-trimester intervention is assumed to be relatively safe. A case of acute transient oligohydramnios, fetal growth arrest and limb reduction anomaly following second-trimester abdominal surgery is reported for the first time.- - - - - - - - - - ranking = 1keywords = abortion (Clic here for more details about this article) |
5/7. Ultrasonographic diagnosis of uterine rent at 33 weeks' gestation with history of curettage.A 30-year-old pregnant woman with a history of an uncomplicated curettage for incomplete abortion was seen at 33 weeks' gestation with decreased fetal movement and intermittent abdominal pain for 1 week. Ultrasonographic evaluation demonstrated a singleton vertex pregnancy, oligohydramnios, and a fundal uterine rent continuous with a large, fluid-filled cystic mass. laparotomy revealed a right cornual uterine rent with hourglass amniotic sac and fluid. A healthy infant was delivered by cesarean section.- - - - - - - - - - ranking = 1keywords = abortion (Clic here for more details about this article) |
6/7. amanita poisoning during the second trimester of pregnancy. A case report and a review of the literature.amanita phalloides-type mushroom poisoning is well recognized as causing acute liver injury and often death. Less is known, however, of whether maternal amanita poisoning is associated with fetal damage or not. In August 1991 four members of a family were hospitalized with food intoxication caused by amanita phalloides and amanita verna. One of them died from hepatic and renal failure. The survivors included a 26-year-old woman in the 23rd week of pregnancy. Her clinical symptoms and blood chemistry data (lowest prothrombin activity 23%) indicated intoxication of medium severity. The management consisted of i.v. hydration, forced diuresis, and administration of silibinin, high-dose penicillin, thioctic acid, hydrocortisone, vitamin k, and fresh frozen plasma. Sonographic and obstetric controls failed to show any fetal abnormalities in the acute phase of poisoning. In the 38th week of pregnancy she gave birth to a healthy baby, who has subsequently undergone an undisturbed development. This observation indicated that severe fetal damage did not occur in maternal amanita poisoning in the second trimester of pregnancy. Thus, at least from the second trimester on, maternal amanita poisoning is not necessarily an indication for induced abortion.- - - - - - - - - - ranking = 1keywords = abortion (Clic here for more details about this article) |
7/7. Nondysplastic fetal renal hypoplasia associated with severe oligohydramnios: clinical, pathologic, and morphometric findings.Two fetuses with severe bilateral renal hypoplasia are described; both diagnoses were made following elective abortion for oligohydramnios and suspected renal dysplasia. A 20-week female fetus (46,XX) had pulmonary hypoplasia and very small kidneys (7% of expected weight) that were normally shaped and nondysplastic, with well-formed medullae and metanephric blastema and markedly diminished cortices with only rare glomeruli. A 23-week male fetus (46,XY) had small kidneys (13% of expected weight) that were nondysplastic, normally shaped, and histologically well organized with moderately decreased numbers of glomeruli. Isolated bilateral renal hypoplasia has not previously been well characterized in fetuses; the presence of oligohydramnios (both cases) and pulmonary hypoplasia (one case) suggests that this finding is associated with impaired fetal renal function and may adversely influence neonatal survival.- - - - - - - - - - ranking = 1keywords = abortion (Clic here for more details about this article) |