CASE 312: FETAL BODY HYPEREXTENSION, Dr PHAN THANH HẢI, Dr JASMINE

THANH XUÂN, Dr ĐẶNG VĨNH PHÚC, Dr TÔ MAI XUÂN HỒNG

Female 33yo with cutaneous allergy from age of 20, now in 3rd pregnancy. 2 first girls are

normal and no abnormal history of family. 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

18weeks: Fetus with normal attitude, heart rate 158b/min, nuchal translucency NT=1.1mm.

Fetal vertebral column normal.

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 movement 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, 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 fetus 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

column changes normal at birth without malformation and babies remain well.