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2003-01-15-14 Answer to the case of the week # 97 Vijayaraghavan ©  www.TheFetus.net


Answer to case # 97

Jun 13 - June 26

Boopathy Vijayaraghavan, MD, DMRD1 R.Lalitha, MBBS, DGO2; Geethanjali, MBBS, DMRD2

1 Sonoscan, Ultrasonic Scan Centre, 16.B Venkatachalam Road, R.S.Puram; 2 Dept of Obstetric and Gynecology, Sri Ramakrishna Hospital, Coimbatore. 641002, India. Obstetric and Gynecology, Sri Ramakrishna Hospital, Coimbatore. 641002, India.

A 25-year-old woman Grade II Para I was referred for sonography to rule out fetal anomalies. She had termination of her first pregnancy at 24 weeks for anencephaly of fetus. There is no history of consanguinity. The period of gestation by LMP was 23 weeks. Fetal biometry corresponded to 23 weeks. The features are diagnostic of a lipomyelomeningocele of lumbar spine. Parents chose to terminate the pregnancy.    

Figure 1 shows normal cranium.

Figure 2 shows spina bifida of lumbar spine and expansion of spinal canal with an echogenic mass in the spinal canal and subcutaneous plane. The skin appears intact.

Figure 3- Longitudinal scan of lumbar spine shows the echogenic mass-producing a bulge on the back in lumbar region.

Figure 4- Coronal Scan of lumbar spine show widening of the spinal canal with an echogenic mass in spinal canal.

Figure 5 – 3D image of the lumbar spine showing the mass.

 

Figure 6 shows the fetus" back. 

Figure 7 displays the MRI of the dead fetus. It shows a mass with fat in the spinal canal of lumbar region extending into subcutaneous plane. There is tethering of cord to skin.


 

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