Karaşahin Kazim Emre, Gezginç Kazim, Alanbay Ibrahim, Ulubay Mustafa, Başer Iskender
Department of Obstetrics and Gynecology, Gulhane Military Medical Academy, Etlik, Ankara, Turkey.
Taiwan J Obstet Gynecol. 2009 Jun;48(2):163-6. doi: 10.1016/S1028-4559(09)60279-5.
We present a case of type I diastematomyelia diagnosed with ultrasonography at the 14th week of gestation.
A 26-year-old primigravida at 14 weeks' gestation was presented to our outpatient department with a complaint of dysuria. Routine antenatal ultrasound revealed disruption of the fetal upper thoracic vertebral column curvature, together with hemivertebrae. Further high-resolution two-dimensional ultrasound examination revealed dilatation of the thoracolumbar vertebrae and extra echogenic foci in the spinal canal. Thoracolumbar meningocele was also observed. These observations (thoracic hemivertebrae, scoliosis and thoracolumbar meningocele) suggested a diagnosis of type I diastematomyelia. The family was counseled regarding the prognosis for the fetus. Their decision to terminate the pregnancy was considered and approved by the ethical council. The postabortion pathologic examination, along with X-ray, three-dimensional computed tomography and magnetic resonance imaging examinations, supported the initial diagnosis.
Prenatal diagnosis of diastematomyelia during the 14th week of pregnancy is possible using high-resolution ultrasound. To the best of our knowledge, this is the earliest case presented in the literature.
我们报告一例在妊娠14周时通过超声诊断出的I型脊髓纵裂病例。
一名妊娠14周的26岁初产妇因尿痛就诊于我院门诊。常规产前超声检查发现胎儿上胸椎脊柱曲度中断,伴有半椎体。进一步的高分辨率二维超声检查显示胸腰椎椎体扩张,椎管内有额外的高回声灶。还观察到胸腰段脊膜膨出。这些观察结果(胸椎半椎体、脊柱侧弯和胸腰段脊膜膨出)提示诊断为I型脊髓纵裂。已就胎儿的预后向其家属提供咨询。他们终止妊娠的决定经伦理委员会审议并批准。流产后的病理检查以及X线、三维计算机断层扫描和磁共振成像检查均支持初步诊断。
使用高分辨率超声在妊娠14周时对脊髓纵裂进行产前诊断是可行的。据我们所知,这是文献中报道的最早病例。