RESUMO
Confined placental mosaicism (CPM) of trisomy 16 is related to intrauterine growth restriction; however, its association with increased nuchal translucency (NT) has not been sufficiently studied. We report the first case involving a diagnosis of CPM for trisomy 16 in a dichorionic twin. Increased NT (3.7 mm) and 1 week of growth retardation at 12 weeks of gestational age were detected in the affected fetus compared with the normal fetus. Given that the biochemical analytes in maternal serum aneuploidy screening of the abnormal fetus were diluted by the presence of the normal fetus, this method was unreliable as a screening tool. Therefore, in dichorionic twins, ultrasonographic findings such as increased NT and early growth retardation can serve as important indicators for the diagnosis of CPM of trisomy 16.
Assuntos
Doenças em Gêmeos/diagnóstico por imagem , Doenças em Gêmeos/genética , Retardo do Crescimento Fetal/genética , Medição da Translucência Nucal , Adulto , Cromossomos Humanos Par 16/diagnóstico por imagem , Feminino , Morte Fetal , Retardo do Crescimento Fetal/diagnóstico por imagem , Humanos , Mosaicismo , Placenta/anormalidades , Placenta/diagnóstico por imagem , Gravidez , Gravidez de Gêmeos , Trissomia , Gêmeos Dizigóticos , Ultrassonografia Pré-NatalRESUMO
We describe a case in which homonymous hemianopsia developed abruptly following an epidural blood patch procedure. The procedure was performed in a patient complaining of post-dural puncture headache after an emergency Cesarean section under spinal anesthesia. Computed tomography and magnetic resonance imaging demonstrated that air bubbles had moved from the prepontine and premedullar cisterns toward the left retrochiasmal region. The homonymous hemianopsia resolved rapidly with conservative management including oxygen, intravenous fluid, and antibiotics. We report on this case with a brief review of the related literature.
