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Saturday, October 9, 2010

Week 7 - OB Case Study by Alexia

Clinical History: 38 year old female presents with pain. LMP is 6/5/2010.

Images:

Image #1:
Fetal Head 1


Image #2:
Fetal Head 2


Image #3:
Fetal Abdomen 1



Image #4:
Fetal Abdomen 2



Image #5:
Femur


Image #6:
Uterus


There is a single, viable, intauterine fetus in variable position of approximately 17 weeks 4 days. The fetal heart rate is 152. The placenta is anterior fundal.
There are 4 pathologies in this case. 2 can be classified as 1 pathology by textbook definition.
I hope you find this case as interesting and challenging as I did.

15 comments:

grace said...

I need to research more to figure out images about head and abdomen. However, Femur looks short by accordance of gestational age. it seems relating to skeletal dysplsia(Rhizomelia?) And very last image, it is fibroid i guess
am I right? :)

Alexia said...

Hi Grace, yes, you are correct, the femur length is relatively short and there is a posterior uterine fibroid. However, there is no confirmation as to skeletal dysplasia at this time. Good job on solving 2 of the 4 pathologies in this case!

Nancy said...

The brain does not appear to have complete calcification of the cranial vault to be able to measure BPD or head circumferance and I see fluid in the brain that could be hydrocephalus or encephalocele.

Alexia said...

The pathologies in this case are intended to be commented on as specific observances, not diagnoses. At this fetal age, more tests would be conducted for a greater understanding of the pathologies that may exist.

Abby said...

In addition to Grace and Nancy's observations, I think I see fetal edema in the head images and abdominal ascites in the abdomen images.

Alexia said...

Yeah Abby you solved the mystery of the fetal head and abdomen!

There is apparent soft tissue thickening at the scalp suspicious for edema. There is free fluid seen within the fetal abdominal cavity, compatible with ascites.

Now, does anyone know the term for the condition when you have these 2 findings or more within the fetal body cavities?

Irene said...

I think the term for this 2 findings where there is fetal edema and ascites is hydrops fetalis/Erythroblastosis Fetalis.
It is complication from several abnormalities.

Alexia said...

Yes Irene, it is Fetal Hydrops!

Mimi said...

Fetal hydrops is a serious fetal condition defined as abnormal accumulation of fluid in 2 or more fetal compartments, including ascites, pleural effusion, pericardial effusion, skin edema, as well as polyhydramnios (excess amniotic fluid) and placental thickening. Hydrops is an end-stage process for numerous fetal diseases.

Anonymous said...

I also do not see the stomach in the fetal abdomen. Maybe there is an abnormality in GI track and polyhydraminos is one of the signs of this pathology.

Hye said...

Mimi said...

Hi Alexia. Are there two different fibroids in the uterus or is there just one?

Leah said...

Hydrops fetalis is a prenatal form of heart failure. Hydrops fetalis usually stems from fetal anemia, when the heart needs to pump a much greater volume of blood to deliver the same amount of oxygen. This anemia can have either an immune or non-immune cause.
Leah

Jessica said...

Fetal hydrops happens when there are 2 or more abnormal fluid collections or edema with in a fetus. Apparently the baby could have had this problem from an Rh sensitivity.

Evgeniya said...

I see free fluid in baby abdomen On the last picture it is a uterine fibroid. Fibroids are better to diagnose before pregnancy. If they are big and growing they mght couse problems during pregnancy.

flore said...

Hydrops fetalis is a condition in the fetus characterized by an accumulation of fluid, or edema, in at least two fetal compartments. The edema is usually seen in the fetal subcutaneous tissue, sometimes leading to spontaneous abortion. It is a prenatal form of heart failure, in which the heart is unable to satisfy its demand for a high amount of blood flow.