Guigue V, Martin A, Mangin M, Arbez-Gindre F, Labenne E, Olivier-Faivre L, Ramanah R, Riethmuller D
Service de gynécologie-obstétrique, clinique universitaire de gynécologie-obstétrique, avenue du 8-Mai-1945, Besançon, France.
J Gynecol Obstet Biol Reprod (Paris). 2011 Sep;40(5):476-80. doi: 10.1016/j.jgyn.2011.01.017. Epub 2011 Mar 8.
In a 30-year-old patient, the systematic second trimester fetal ultrasound discovered major facial abnormalities suggesting a frontonasal dysplasia (FND). The fetal karyotype was normal but no additional genetic testing was performed. Fetal MRI found an important hypertelorism and an asymmetric cerebral ventricle, with a partially visualized corpus callosum. After several consultations and interviews, the couple made a formal demand for pregnancy interruption, which was approved. Fetal pathologic examination confirmed the diagnosis of FND with no other major associated malformation. This rare pathology results from a midline facial dysgraphia comprising a hypertelorism, a large nasal base, a large clefted nose tip and, a V-shaped hair implantation on the forehead. It often occurs sporadically, of unknown cause, related to a defect in the embryonic nasal capsule development. Syndromic forms have been described with cerebral lesions and possible intellectual deficiency. Consequently, a long and difficult surgical management is necessary, at the expense of poor aesthetic outcome. Seven cases of prenatally diagnosed FND have been reported in the literature, three of which had 3D ultrasound.
在一名30岁的患者中,孕中期系统性胎儿超声检查发现主要面部异常,提示额鼻发育异常(FND)。胎儿核型正常,但未进行其他基因检测。胎儿磁共振成像(MRI)发现明显的眼距过宽和不对称脑室,胼胝体部分可见。经过多次会诊和面谈,这对夫妇正式要求终止妊娠,该请求获得批准。胎儿病理检查确诊为FND,无其他主要相关畸形。这种罕见的病理情况是由中线面部书写障碍引起的,包括眼距过宽、宽大的鼻基底、宽大的鼻尖裂和前额呈V形的毛发植入。它通常散发性发生,病因不明,与胚胎鼻囊发育缺陷有关。已描述了伴有脑部病变和可能智力缺陷的综合征形式。因此,需要进行漫长而困难的手术治疗,且美容效果不佳。文献中报道了7例产前诊断为FND的病例,其中3例进行了三维超声检查。