Department of Obstetrics & Gynecology, Jimma University Medical Center, Jimma, Ethiopia.
J Med Case Rep. 2020 Oct 29;14(1):205. doi: 10.1186/s13256-020-02509-3.
Body stalk anomaly is a generally lethal malformation of the thorax and/or abdomen. It is often associated with limb defects. The intrathoracic and abdominal organs lie outside the abdominal cavity. These are contained within a sac composed of amnioperitoneal membrane attached directly to the placenta. The umbilical cord may be totally absent or extremely shortened. Severe kyphoscoliosis is often present. This case is reported to highlight this rare malformation and its clinical presentation.
We present a case of a 27-year-old primigravida Oromo woman who had been amenorrheic for 9 months. She presented with an urge to bear down of 10 hours and passage of liquor of the same duration. The patient was referred from a district primary hospital with a diagnosis of preterm labor and hand prolapse. A lower uterine segment cesarean section was performed at Jimma University Medical Center for an indication of active first stage of labor with nonreassuring fetal heart rate pattern (fetal bradycardia) and hand prolapse to effect an anomalous fetus that had only a rudimentary right lower extremity and liver and intestine found outside the abdominal cavity contained within a sac composed of transparent membrane attached directly to the placenta. The umbilical cord was very short, measuring about 7 cm. The fetus had severe scoliosis. It also had a heartbeat upon extraction, which stopped after 5 minutes of delivery. The placenta and fetal body parts together weighed 2400 g.
Termination of pregnancy is usually offered because this abnormality is generally considered lethal. If the pregnancy is continued undetected as in our patient's case, vaginal delivery is recommended, given the highly lethal nature of this anomaly. Good prenatal screening and counseling are recommended for early detection and management.
体干畸形是一种常见的胸部和/或腹部致死性畸形。它通常与肢体缺陷有关。胸腔和腹部器官位于腹腔外。这些器官位于由与胎盘直接相连的羊膜腹膜组成的囊中。脐带可能完全缺失或极度缩短。严重的脊柱侧凸通常存在。本病例报告旨在强调这种罕见的畸形及其临床表现。
我们报告了一例 27 岁的初产妇奥罗莫妇女，闭经 9 个月。她出现了 10 小时的强烈分娩冲动，并伴有相同时间的羊水漏出。患者因早产和手脱出的诊断从地区一级医院转来，表现为活跃的第一产程，伴有不可靠的胎儿心率模式（胎儿心动过缓）和手脱出，以影响异常胎儿，该胎儿仅具有基本的右下肢体，肝脏和肠管位于腹腔外，位于由直接附着于胎盘的透明膜组成的囊中。脐带非常短，约 7 厘米。胎儿有严重的脊柱侧凸。取出后仍有心跳，但分娩后 5 分钟停止。胎盘和胎儿身体部分一起重 2400 克。
通常建议终止妊娠，因为这种异常通常被认为是致命的。如果像我们患者的病例一样，未检测到继续妊娠，建议进行阴道分娩，因为这种异常的致死性极高。建议进行良好的产前筛查和咨询，以实现早期发现和管理。
