Dolicocefalia & Hidrops & Riñones Poliquisticos & Oligohidramnios
Paciente femenina, 20 años, gesta 1 Parto 0. Cursando embarazo de 17
semanas hasta ahora sin nada relevante. Viene a revisión de segundo
nivel tras ser examinada en otro centro donde se reporta feto con
liquido en el abdomen. El examen sonografico muestra producto podalico
con dolicocefalia ( definido por un aumento del diámetro antero-posterior debido a fusión
prematura de la sutura sagital, e indice cefálico entre 65 y 75
)
75% (hembra), 65% (macho) : dolicocefálico.
- 75%-80% (hembra), 65%-75% (macho) : mesocefálico.
- 80% (hembra), 75% (macho) : braquicefálico.
El abdomen fetal aparece ocupado por masa liquida ( hidrops fetal ) y
mega-vejiga con mega-uréter, los órganos internos ( hígado,bazo y
riñones lucen de pequeño tamaño, hipotroficos), ademas los riñones
muestran múltiples quistes que ocupan todo el parénquima ( riñones
poliquisticos). El fémur, tibia y humero muestran dimensiones normales.
Se comprueba ausencia absoluta de liquido amniótico ( Oligohidramnios
severo ). La madre es grupo sanguíneo A Rh (+ ), el padre no conoce su
grupo sanguíneo o Rh. Se concluye por consiguiente que se trata de
malformaciones incompatibles con la vida fetal y así lo explicamos a la
embarazada y a su madre.Debido a que la madre tiene cierto grado de
exoftamos tenemos la sospecha que la causa podría ser la
incompatibilidad sanguínea de los padres o hipertiroidismo de la madre,
ambas cosas deben ser evaluadas ,sobre todo para el futuro.
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Dolichocephaly & Hydrops & Polycystic Kidney & Oligohydramnios
Female patient, 20 years old,
gravida one 0 birth coursing
17 weeks pregnant
so far without
anything relevant. It comes with
second-level reviews
after being
examined in
another center where the liquid has reported a fetus
in the abdomen. The
sonographic examination
shows breech
product
dolichocephaly
(defined
by increased
anteroposterior
diameter due to
premature fusion
of the sagittal suture,
and cephalic index
between 65 and 75)
The cephalic indices are:
75 % (female), 65 % (male): dolichocephalic.
75% -80 % (female), 65 % -75 % (male): mesocephalic.
80 % (female) 75 % (male): brachycephalic.
The fetal abdomen is occupied by liquid mass (fetal hydrops) mega-ureter and mega-bladder, internal organs (liver, spleen, and kidneys look small, hypotrophic, kidneys also showed multiple cysts that occupy the entire parenchyma ( polycystic kidneys ). the femur, tibia, and humerus show normal size. absolute absence of amniotic fluid (Oligohydramnios severe) is checked. the mother is blood group an Rh (+), the father does not know his blood or Rh group. We conclude therefore that is fetal malformations incompatible with life and so we explained to the pregnant woman and her mother. Because the mother to have some degree of exoftamos we suspect that the cause could be the blood incompatibility of parents or maternal hyperthyroidism, both should be evaluated, especially for the future.
The cephalic indices are:
75 % (female), 65 % (male): dolichocephalic.
75% -80 % (female), 65 % -75 % (male): mesocephalic.
80 % (female) 75 % (male): brachycephalic.
The fetal abdomen is occupied by liquid mass (fetal hydrops) mega-ureter and mega-bladder, internal organs (liver, spleen, and kidneys look small, hypotrophic, kidneys also showed multiple cysts that occupy the entire parenchyma ( polycystic kidneys ). the femur, tibia, and humerus show normal size. absolute absence of amniotic fluid (Oligohydramnios severe) is checked. the mother is blood group an Rh (+), the father does not know his blood or Rh group. We conclude therefore that is fetal malformations incompatible with life and so we explained to the pregnant woman and her mother. Because the mother to have some degree of exoftamos we suspect that the cause could be the blood incompatibility of parents or maternal hyperthyroidism, both should be evaluated, especially for the future.
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