Prenatal diagnosis of fetal microhydranencephaly: a case report and literature review

BMC Pregnancy and Childbirth

Keiya Fujimori¹  Shogo Kin²  Takahiro Omoto³  Toshifumi Takahashi⁴ 

[1] Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, 960-1295, Fukushima City, Japan;Department of Obstetrics and Gynecology, Takeda General Hospital, 965- 8585, Aidu Wakamatsu, Japan;Department of Obstetrics and Gynecology, Takeda General Hospital, 965- 8585, Aidu Wakamatsu, Japan;Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, 960-1295, Fukushima City, Japan;Fukushima Medical Center for Children and Women, Fukushima Medical University, 1 Hikarigaoka, 960-1295, Fukushima City, Japan;

关键词: Microhydranencephaly;    Anencephaly;    Prenatal diagnosis;    Microcephalus;    Hydrocephalus;   

DOI  :  10.1186/s12884-020-03400-1

来源: Springer

【 摘 要 】

BackgroundThe prenatal diagnosis of microhydranencephaly is important and needs to be distinguished from anencephaly, because unlike anencephaly, fetuses with microhydranencephaly can survive after birth. Herein, we report a case of microhydranencephaly that was diagnosed and distinguished from anencephaly prenatally.Case presentationThe patient was an 18-year-old woman, 2 gravida nullipara, who presented at 15 weeks of gestation. Ultrasonography showed a normal biparietal diameter (BPD) and no major anomalies. At 23 weeks of gestation, an ultrasound examination revealed a BPD of 40 mm (-5.3 standard deviation, SD). At 29 weeks, anencephaly was suspected despite difficulty in visually examining the fetal head above the orbit. At 34 weeks, insertion of a metreurynter made it possible to observe the skull. Three-dimensional computed tomography (CT) and magnetic resonance imaging (MRI) confirmed the presence of the fetal skull, a prominent occipital bone, sloping forehead, marked microcephaly, cerebral loss, and excess cerebrospinal fluid. This allowed differentiation between microhydranencephaly and anencephaly. She delivered vaginally at 37 weeks, and the child had a birth weight of 2342 g and a head circumference of 24 cm (-5.4 SD). The baby’s head was flat above the forehead, with a suspected partial head defect. The baby received desmopressin acetate due to central diabetes insipidus 6 months after birth.ConclusionsThe use of multiple imaging modalities and physical manipulation of the fetal head are required to accurately differentiate between microhydranencephaly and anencephaly.

【 授权许可】

CC BY