Anahtar Kelimeler: Fetus ve Yeni doğanın Hemolitik Hastalığı, Kell Alloimmunizasyonu,
İntrauterin transfüzyon
Şekil 1
[PP-071]
Lateral Cervical Mass: Prenatally detected Lymphangioma and postnatal management: a case report
Selen Gürsoy Erzincan1, Cihan Inan1, N. Cenk Sayın1, Mustafa Inan2, Füsun G. Varol1 1Trakya University Faculty of Medicine, Department of Obstetrics & Gynecology, Division of Perinatology, Edirne, Turkey
2Trakya University, Faculty of Medicine, Department of Pediatric Surgery, Edirne, Turkey
Introduction: Lymphangiomas are commonly located in the soft tissue at the posterior neck region. We present the prenatal sonographic findings and postnatal outcome of a fetus with a huge lateral cervical lymphangioma.
Case: A 21-year-old patient, gravida 1,para 0, was referred to our antenatal clinic at 28 weeks of gestation. Prenatal ultrasound and magnetic resonance imaging revealed a 83x62x74 mm cystic, septated, multilocular mass in the left lateral cervical region. On second level ultrasound no additional abnormality was detected except the edematous face of the fetus. The patient did not accept karyotype analysis. Although the mass increased in size (to 121x68x101 mm), no remarkable change was observed in the shape and texture of the mass. Cardiac failure, polyhydramnios or hydrops were not developed in the antenatal period. A male baby weighing 3715 gr was delivered by cesarean section with classical incision at 39 weeks’ of gestation, but EXIT procedure did not needed. Chromosomal analysis revealed normal karyotype and the
newborn was operated by pediatric surgeons because of respiratory difficulty and feeding problems on the X0rd day. He is alive and gocondition in the 2nd month of life.
Discussion: Multidisciplinary team approach is necessary for dealing with giant neck masses. Delivery of the fetus should be planned in a center capable of both managing potential immediate breathing and feeding problems.
Figure 1
[PP-072]
Neurodevelopmental outcomes of premature infants
Curteanu Ala, Pinzari Ludmila, Jitarciuc Ala, Caraus Tatiana Mother and Child Institute, Chisinau, Republic of Moldova
The study’s objective was to assess neurodevelopment in premature infants.
Methods. The case notes of 155 babies with 6 follow-ups done, the last done at 2 years corrected age (c.a.), were analyzed. Children were divided into two groups: I - 128 children with birth weight (BW) less then 1500g and II - 27 children with BW more than 1500g. We used the Bayley Scales of Infant Development III to evaluate neurodevelopment.
Findings. Severity of neurodevelopmental impairment at 2 years c.a. was more advanced in children from group I due to a more complicated evolution of neonatal period because of infectious complications, respiratory (respiratory distress syndrome) and cerebral (intraventricular
hemorrhage (IVH), p<0,05, periventricular leukomalacia (PVL), p<0,05 and seizures, p <0,05) complications associated with prematurity. Evolution of the neurodevelopmental diagnoses at 2 years showed 71 (66,36%) children from group I and 17 (73.91%) children from group II were diagnosed as healthy. Severe neurological disorders prevailed also in the group I of children in
13,08% (14) cases being represented in 9,35% of cerebral palsy, hydrocephaly / ventriculomegaly and microcephaly both per 1,87% of cases.
Conclusions. Neurodevelopment outcomes in children with BW less than 1500g was more compromised compared to children with a bigger weight due to extreme prematurity cases, prematurity severe complications, which led to the development of more frequent CP, post-hemorrhagic hydrocephalus and microcephaly.
Keywords: Neurodevelopment, premature baby, cerebral palsy
[PP-073]
Electronic register for monitoring congenital malformations and hereditary diseases in Moldova
Curteanu Ala, Caraus Tatiana
Mother and Child Institute, Chisinau, Republic of Moldova
In Moldova about 700 children with various forms of congenital malformations (CM) and hereditary diseases (HD) are born annually. Monitoring is one of preventive measures aimed to reduce CM. The objective of this study was to determine prevalence, structure and risk factors for CM and HD recorded in the Electronic Register for monitoring CM in the country in 2013.
Methods. The object of the study were children (live and dead) and fetuses with isolated or multiple CM reported by maternity wards. Thus, 721 cases of CM and HD were registered, of which - 252 cases were suspected at ultrasound examination, 28 cases - after interruption of pregnancy at 28 weeks of gestation and 693 cases were detected during postnatal period during physical
examination, instrumental examinations, screening, surgical interventions in children or pathological examination of deceased children at 1 year of life.
Findings. The prevalence of CM was 16 per 1000 births. Congenital malformations structure included: cardiac defects (21,1%), malformations of musculoskeletal (17,2%), urogenital and reproductive (14,3%) and gastrointestinal systems (13,3%). The major risk factors include: maternal age greater than 35 years, Gagauz and Ukrainian ethnicity.
Conclusion. The unique Electronic Register on CM monitoring allows increasing the complexity of CM collection, as well to analyzing all cases of CM registered by different parameters such as: age, ethnicity, maternal occupation, harmful habits, etc.
Keywords: Congenital malformation, Electronic Register, monitoring
[PP-074]
Dandy walker syndrome prenatal diagnosis with ultrasound
Ilir Kadiri, Bleta Domi, Butrint Kusari, Qamil Hamza, Aida Kumnova Regional Hospital Gjakova /Kosova. Department of perinatalogy.
The Dandy-Walker complex is a rare congenital intracranial malformation that comprises a spectrum of abnormalities of the posterior fossa which are classified as
(a) Dandy-Walker malformation (cystic dilatation of the 4th ventricle, complete or partial agenesis of the cerebellar vermis and an enlarged posterior fossa)
Findings:
A 28 year old primi gravida come in the routine ultrasound of the perinatal at 20 week of gestation. Ultrasonography revealed a single live intra-uterine gestation with biparietal diameter and fetal Femur length corresponding to 22 weeks of gestation. The fetal posterior fossa was of normal size but with a large anechoic lesion which was communicating with the 4thventricle. There was a suggestion of hypoplasia of the cerebellar vermis (Fig.1) but no evidence of hydrocephalus. The measurements of the fetus was normal the FW 270 gr, umbilical cord with one vein and one artery,cerebellum was18mm but cysterna magna was large 10mm.In Ultrasound scan it was not possible to see the vermis.
It was diagnosed Dandy Walker Syndrome and the patents did not want to do the prenatal diagnosis with amniocentesis.
aborted the fetus 280 grams with no facial malformations only in each leg was 4 fingers and in each hand was 6 fingers.
Keywords: Dandy walker syndrome, ultrasound