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 2002-07-26-12 Case of the week #77 © Sepulveda

Case #77

July 27-August 9, 2002

Sebastian Illanes, MD, Cristian Kottmann, MD, Waldo Sepulveda, MD

Department of Obstetrics and Gynecology, Hospital Parroquial, Universidad Los Andes, San Bernardo Fetal Medicine Center, Clinica Las Condes, Santiago, Chile

A 29-year-old primigravida was referred at 30 weeks’ gestation for an ultrasonographic examination to evaluate fetal growth after a positive screening for gestational diabetes. Her previous medical history was non-contributory and a first trimester scan, performed because of uncertain dates, revealed a biometry consistent with a 14-week fetus and no obvious fetal anomalies.


A local scan before a referral at 28 weeks revealed suboptimal fetal growth but normal amniotic fluid volume. At referral, the fetal growth was below the 10th centile, normal Doppler and normal amniotic fluid volume. In addition, the following images were obtained.


There was no nuchal thickening, and the four chamber view was reported as normal. A presumptive diagnosis of Hereditary lymphedema I . Accordingly, prenatal karyotyping was not recommended. Follow-up scans were done weekly and an elective cesarean section was performed at 37 weeks’ gestation delivering a 2900 g female fetus with Apgar scores of 9 and 9 at 1 and 5 minutes, respectively.

What is (are) the finding(s), and the name of the condition ?

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