2003-08-12-09 Case of the week #106 © Duchatel www.thefetus.net/

Case of the week #106

October 31-November 13, 2003

François Duchatel MD

CHU Pontoise, France

A 25-year-old patient, G3, P2, is treated by her physician at 9 weeks 2 days of gestational age.

An amniocentesis was performed at 19 gestational weeks. The alpha fetoprotein was at 1194mg/1 (n < 3250 mg/1), the acetylcholinesterase normal. 

An ultrasound performed at 20 weeks 3 days demonstrates teh following images. The biometry is normal, between the 30^th and 40^th percentile.

Ten days later, at 21 weeks 4 days, neither of the findings above could be seen.

An ultrasound performed at 24 weeks 3 days is normal with a biometry between the 25^th and 30^th percentile. No limb anomalies are noted.

At 29 weeks, the biometry is between the 10^th and 40^th percentile. The following are images of the feet. No fetal breathing is noted.

At 31 weeks, a male fetus was born under peridural anesthesia, weighing 1350g (which is in the 30^th percentile for the age). The head perimeter is 302mm, which is between the 50^th and 90^th percentile for the age. The Apgar was 1 at 1 minute. The child was intubated and put on a ventilator immediately, cared for by the neonatal intensive care unit.