RESUMEN
Five cases of abnormality in twin pregnancies, detected by ultrasound examination during the second trimester, are reported. In four pregnancies there was a fetal malformation: discordant anencephaly, a monozygotic, heterokaryotypic twin pregnancy with coexistant Turner's syndrome and intrauterine death, concordant body stalk syndrome, and a dicephalus monster. In the other pregnancy one fetus dies in utero to become a fetus papyraceous. Four of the pregnancies were associated with raised levels of maternal serum alpha-fetoprotein, by singleton standards. Ultrasound examination proved of value in each case. Three pregnancies were terminated.
Asunto(s)
Anomalías Congénitas/diagnóstico , Enfermedades en Gemelos , Embarazo Múltiple , Diagnóstico Prenatal , Ultrasonografía , Adulto , Femenino , Humanos , Embarazo , Segundo Trimestre del Embarazo , alfa-Fetoproteínas/análisisRESUMEN
Five cases of twin pregnancy associated with elevated maternal serum alpha-fetoprotein levels are presented. In each instance an abnormality was detected by ultrasound examination--in four cases this represented anomalous development of one or both fetuses: discordant anencephaly; a monozygotic heterokaryotypic twin pregnancy with coexistent Turner's syndrome and intrauterine death; concordant body-stalk syndrome; and fetal exomphalos together with an acardiac monster. In the remaining case, there had been an intrauterine death of one of the twins. Ultrasound examination proved valuable in all instances; three pregnancies were terminated and single healthy infants were delivered from each of the other two pregnancies.
Asunto(s)
Anomalías Congénitas/diagnóstico , Embarazo Múltiple , Diagnóstico Prenatal , Ultrasonografía , alfa-Fetoproteínas/análisis , Femenino , Humanos , Recién Nacido , Embarazo , GemelosRESUMEN
In a series of 366 patients identified as at risk for a fetal neural tube defect (NTD) before the 24th week of pregnancy, 64 had an abnormal fetus. The abnormalities included anencephaly (39), open spinal defect (17), closed spinal defect (2), encephalocele (1), and a miscellany of other abnormalities (5). An ultrasound examinaton prior to diagnostic anmiocentesis positively identified all anencephalic fetuses, the fetus with the encephalocele, and 15 of the 19 fetuses with spina bifida. The spinal defects in 3 of the remaining 4 fetuses were demonstrated at a second examination. Since both amniotic fluid alpha-fetoprotein (AFP) assays and ultrasound examination have been shown to give false results in the diagnosis of NTDs, the importance of using 2 independent diagnostic techniques is stressed. In patients with elevated levels of maternal serum AFP, a careful ultrasound examination, in addition to identifying the majority of cases associated with an abnormal fetus, provided a good explanation for the elevation in over half of the remainder. In this series more than half the patients (40/69) who underwent amniocentesis because of raised maternal serum AFP levels were shown to have an abnormal fetus.
Asunto(s)
Enfermedades Fetales/diagnóstico , Defectos del Tubo Neural/diagnóstico , Ultrasonografía , Líquido Amniótico/análisis , Anencefalia/diagnóstico , Encefalocele/diagnóstico , Femenino , Humanos , Meningomielocele/diagnóstico , Embarazo , Espina Bífida Oculta/diagnóstico , alfa-Fetoproteínas/análisisAsunto(s)
Diagnóstico Prenatal/métodos , Ultrasonografía , Peso Corporal , Anomalías Congénitas/diagnóstico , Femenino , Retardo del Crecimiento Fetal/diagnóstico , Feto/fisiología , Edad Gestacional , Humanos , Tamizaje Masivo , Defectos del Tubo Neural/diagnóstico , Folículo Ovárico/crecimiento & desarrollo , Placenta , Embarazo , GemelosRESUMEN
Antenatal ultrasound diagnoses of gross lymphatic system abnormalities were made in three fetuses. Although the diagnosis was made in only 1 fetus at a stage early enough in pregnancy to allow selective termination, knowledge of the abnormality in the remaining 2 fetuses proved to be valuable for subsequent management of those pregnancies. It is stressed that the extent of the abnormality must be carefully assessed because of the possibility of corrective surgery should the lesion be small and that the parents must be given detailed counseling before any definitive measures are taken.