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2007-01-17-14 Answer to the case of the week #194 © Werner www.TheFetus.net

Answer to the case of the week #194 

May 31 - June 14, 2007

Heron Werner, MD*, Iugiro Kuroki, MD*, Erick Malheiro L. Martins, MD**

* Clinica de Diagnostico por Imagem - CDPI, Rio de Janeiro, Brazil. **Clinica Lagos Ultrasonografia, Riod de Janeiro, Brazil.

A 32-year-old patient, G8P7, with unremarkable history. First ultrasound at 28th week of gestation. Because of the anomalies we performed an abdominal CT at 37 weeks. Here are some of the images we obtained.

Images 1, 2. Normal fetal profile and humerus at 28th week of gestation.

 

Images 3, 4. 3D normal fetal face and humerus at 28th week of gestation.

 

Images 5, 6. The CT images at 37 weeks. Note absence of the inferior limbs, right upper extremity and left forearm.

 

Images 7, 8. The CT images at 37 weeks. Note absence of the inferior limbs, right upper extremity and left forearm.

 

Image 9. The CT images at 37 weeks. Note absence of the inferior limbs, right upper extremity and left forearm.

Image 10. Postnatal appearance.

The final diagnosis was amelia of the lower limbs with transverse hemimelia of the upper limbs.

CT with three-dimensional (3D) reconstructions can be an important and accurate imaging modality to evaluate skeletal malformations in the third trimester of the pregnancy. The dose to the uterus from an abdominal CT is 10 mGy (1 rad), and the dose to the uterus from an abdominal and pelvic CT is 30 mGy (3 rads).

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