Fabrice Cuillier, MD.

Department of Gynecology, Félix Guyon Hospital, 97400 Saint-Denis, Ile de la Réunion, France.

Case report

A 40-year-old woman, G3 P2, was scanned at 11 weeks of gestation. We revealed the following findings:

Increased nuchal translucency, NT=6 mm.
Hydrops
Bilateral cleft lip with maxillar prominence
Mesocardia

The maxillar prominence was imitating an image of the proboscis but was located at the level of the mouth not at the level of the eyes. All extremities were of normal appearance, brain anatomy seemed normal as well.

Patient decided for the pregnancy termination based on the ultrasound findings. The karyotype of the fetus was normal. The pathology examination confirmed our ultrasound findings.

Images 1,2: Increased nuchal translucency, NT=6 mm.

Images 3-6: Images 3-5 show an axial view of the cleft, the protruding lobe is a maxillar prominence forming the upper lip. Image 6 shows the axial view of the fetal brain with normal choroid plexus and two hemispheres.

Images 7,8: 3D-images obtained via vaginal probe showing cleft lip and maxillary prominence.

Images 9,10: Transverse view of the thorax with heart shifted to the midline, mesocardia. Note the fetal hydrops.

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