|IMAGING FOR RESIDENTS – QUIZ
|Year : 2021 | Volume
| Issue : 2 | Page : 148-149
Skeletal defect at first-trimester ultrasound scan
Marilia Freixo, Elisa Soares, Maria Coelho, Carla Marinho, Juliana Rocha, Graça Rodrigues
Department of Obstetrics and Gynaecology, Centro Hospitalar Tâmega E Sousa, Porto, Portugal
|Date of Submission||29-Apr-2020|
|Date of Decision||19-May-2020|
|Date of Acceptance||02-Jun-2020|
|Date of Web Publication||24-Aug-2020|
Dr. Marilia Freixo
Department of Obstetrics and Gynaecology, Centro Hospitalar Tâmega E Sousa, Porto
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Freixo M, Soares E, Coelho M, Marinho C, Rocha J, Rodrigues G. Skeletal defect at first-trimester ultrasound scan. J Med Ultrasound 2021;29:148-9
|How to cite this URL:|
Freixo M, Soares E, Coelho M, Marinho C, Rocha J, Rodrigues G. Skeletal defect at first-trimester ultrasound scan. J Med Ultrasound [serial online] 2021 [cited 2021 Aug 6];29:148-9. Available from: http://www.jmuonline.org/text.asp?2021/29/2/148/293253
| Section 1 – Quiz|| |
We report a case of a nulliparous 36-year-old Portuguese woman at 14 weeks of gestation for her first prenatal visit in our hospital. The medical history was unremarkable without known underlying conditions (medical or surgical).
In ultrasound (US) performed at 14 weeks and 3 days, we found a singleton live fetus with normal amniotic fluid volume. Fetal biometry was not consistent with late period date because the crown rump length was found to be smaller than expected. The fetal anatomy above the midthorax, including the heart and the intracranial structures, appeared normal. Below this level, however, a sudden termination of the spine at lumbosacral level was seen [Figure 1]. In the transverse section, the sacrum was missing and the iliac wings are positioned in midline close to each other [Figure 2].
The lower limbs were akinetic and were kept in fixed flexion [Figure 3] and [Figure 4]. The fetus had clubfeet [Figure 5]. The bladder was not observed and the bowel was hyperechogenic [Figure 6].
|Figure 3: Ultrasound: Transversal view - Fixed flexion of lower limbs 15|
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Combined first-trimester screening was performed and revealed a reduced risk for trisomy 21 (1:13494), trisomy 18 (1:91068), and trisomy 13 (1:76419) with pregnancy-associated plasma protein-A = 0.68 MoM and free beta-human chorionic gonadotropin = 0.60 MoM.
Taking into account the US findings, a cytogenetic study was proposed, which revealed a normal array-comparative genomic hybridization. The postabortion study confirmed the US findings.
| What is the Diagnosis?|| |
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 identity, but anonymity cannot be guaranteed.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
[Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5], [Figure 6]