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2011-01-06-13 Hydrocephalus with multiple fetal anomalies © Asali 
Hydrocephalus with multiple fetal anomalies

Al-Hammadi Hospital, Riyadh, Saudi Arabia.
Case report

A 22-year-old G2 P1 came to the Labor and Delivery Department for the mild uterine contractions at 28 weeks of gestation. Her marriage was a first degree consanguineous. Her first baby was healthy.
The ultrasound scan showed a multiple congenital anomalies.

  • Severe hydrocephalus
  • Scalp edema, pleural effusion
  • Bilateral clenched fists with overlapping fingers
  • Bilateral clubfoot
  • Facial dysmorphic features: low set ears, flat profile, micrognathia, hypertelorism, down-slanting palpebral fissures
  • Markedly increased amount of the amniotic fluid

Parents did not agree with karyotyping of the baby, our differential diagnosis included chromosomal abnormality (trisomy 18), Arthrogryposis, akinesia sequence.

Images 1,2
: Image 1 shows a severe bilateral ventriculomegaly, note scalp edema. Image 2 shows a clenched fist and increased amount of the amniotic fluid.

Images 3,4: Images show pleural effusion.

Images 5,6
: Image 5 shows a fluid in the thorax, located above the diaphragm. Image 6 shows a 3D view of the clubfoot. 

Images 7,8: Image 7 shows upper extremities with clenched fists. Image 8 shows dysmorphic facial features, low set ears, micrognathia.

Images 9-11
: Images of the neonate, note position of the upper and lower extremities and the facial features.


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