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Table of Contents
IMAGING FOR RESIDENTS QUIZ
Year : 2020  |  Volume : 28  |  Issue : 1  |  Page : 54-55

Abdominal wall defect found at the first-trimester ultrasound scan


Department of Obstetrics and Gynaecology, Centro Hospitalar Tâmega E Sousa, Porto, Portugal

Date of Submission28-Dec-2018
Date of Decision27-Feb-2019
Date of Acceptance28-Mar-2019
Date of Web Publication07-Aug-2019

Correspondence Address:
Marília Freixo
Department of Obstetrics and Gynaecology, Centro Hospitalar Tâmega E Sousa, Porto
Portugal
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/JMU.JMU_130_18

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How to cite this article:
Freixo M, Soares E, Coelho M, Marinho C, Pinto AR, Rodrigues G. Abdominal wall defect found at the first-trimester ultrasound scan. J Med Ultrasound 2020;28:54-5

How to cite this URL:
Freixo M, Soares E, Coelho M, Marinho C, Pinto AR, Rodrigues G. Abdominal wall defect found at the first-trimester ultrasound scan. J Med Ultrasound [serial online] 2020 [cited 2022 Aug 13];28:54-5. Available from: http://www.jmuonline.org/text.asp?2020/28/1/54/264064




  Section 1 – Quiz Top


Case description

We report a case of a nulliparous 28-year-old Portuguese woman at 14 weeks of gestation for her first prenatal visit. She was healthy without known underlying conditions or surgical history.

The first trimester combined screening revealed a reduced risk for trisomy 21 (1:4403), trisomy 18 (1:55517), and trisomy 13 (1:42660) with pregnancy-associated plasma protein-A = 0.58 MoM and free beta-human chorionic gonadotropin = 0.59 MoM.

In ultrasound (US), we found a live fetus with indeterminable crown-rump length due to the inability of obtaining a full longitudinal view of the appropriate structures [Figure 1] and [Figure 2]. The nuchal translucency was impossible to measure [Figure 3].
Figure 1: Ultrasound: Indeterminable crown-rump length

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Figure 2: Ultrasound: Abnormal spine suggesting scoliosis

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Figure 3: Ultrasound: Longitudinal view of the head

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The fetus appeared fixed in position. There was a severe midline defect of the fetal abdominal wall with a protruding abdominal mass adherent to the placenta suggesting an evisceration of the abdominal contents [Figure 4]. The cord insertion site could not be identified, and no free-floating loops of the cord were seen. In a cross-sectional view of the abdomen, there was a marked deviation of misalignment of the lower limbs [Figure 5]. The placenta was located on the anterior wall of the uterus, and the amniotic fluid amount was normal. Cytogenetic study for aneuploidy revealed a normal karyotype. The postabortion study confirmed the US findings [Figure 6] and [Figure 7].
Figure 4: Ultrasound: Abdominal mass adherent to the placenta surface

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Figure 5: Ultrasound: Cross-section view of the abdomen-deviation of the lumbar spine and misaligned lower limbs

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Figure 6: Postabortion images-severe kyphoscoliotic with asymmetric lower limbs and evisceration of the abdominal contents

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Figure 7: Postabortion images-severe kyphoscoliotic with asymmetric lower limbs and evisceration of the abdominal contents

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  What Is the Diagnosis? Top


Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient has given her consent for her images and other clinical information to be reported in the journal. The patient understands that her name and initial will not be published and due efforts will be made to conceal her identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.




    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5], [Figure 6], [Figure 7]



 

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