| Autor: |
Sook Ling Lee, Tan, W. C, Tan, H. K |
| Předmět: |
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| Zdroj: |
Journal of Perinatal Medicine; 2017 Supplement, Vol. 45, p333-333, 1p |
| Abstrakt: |
Introduction: Observations have shown that loss of one twin in the first trimester does not appear to impair the development of surviving twin. Cytogenetic studies have also shown that occurrence of trisomy 21 in twin pregnancies is low. Case report: Mdm M was a 33 year-old Malay female; on metformin for Diabetes Mellitus type II for two years. First trimester scans: (i) Viability scan at 7+2 weeks showed two gestational sacs containing two viable embryos; (ii) Viability scan at 9 weeks confirmed dichorionic-diamniotic pregnancy. Crown-rump length was 23 mm and 3 mm respectively with no heart pulsations in the smaller embryo; (iii) First trimester screening (FTS) at 12+4 weeks noted nuchal ranslucency of 3.4 mm, nasal bone was hypoplastic. FTS was high risk for aneuploidy,Trisomy 21 >1:4. Patient declined amniocentesis. Second trimester ultrasound: (i) Fetal screening scan at 21+1 weeks noted abdominal circumference and femur length just above 5th percentile. (ii) At 24+1 weeks, Head circumference (HC), AC and FL remained on the 5th percentile, Umbilical artery pulsatility index (UAPI) was above 95th percentile. Follow-up scan showed similar findings. At 28+2 weeks, Absent end-diastolic flow was noted in UAPI with positive 'A' wave in ductus venosus. Antenatal corticosteroids and magnesium sulphate for cerebral palsy prophylaxis were administered. Emergency caesarean section was performed at 28+4 weeks for Non reassuring fetal status Results: Female baby of 770g was delivered. Karyotype revealed Trisomy 21. Conclusion: Studies addressing the risk of aneuploidy with diabetes have suggested that chromosomal abnormalities occurring with pre-existing diabetes are likely to be associated with the risks of increasing maternal age. Preconception counseling may be beneficial for patient. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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