Prenatal intraventricular hemorrhage in a term infant with congenital CMV infection

Intraventricular hemorrhage (IVH) occurs rarely in term infant, since subependymal area is a transient structure in fetal life. IVH in term infant indicates generally that it happened prenatally. Congenital cytomegalovirus (CMV) infection is frequent, occurring in 1% of live births. It is a severe infection leading to developmental defects, especially sensorineural deafness. The diagnosis of congenital CMV infection is rarely evoked in term eutrophic newborn. We report a term male neonate born to a 32-year-old mother gravida 2, para 2. Pregnancy was uneventful. Ultrasound follow-up was unmarked. The newborn was eutrophic, birth weight was 3400g, length was 49cm, and head circumference 33cm. Neonatal examination showed no anomalies. On the first day of life, blood cells count performed for suspected materno-fetal infection discovered fortuitous thrombocytopenia at 30 x 109/L. Within the second day of life, platelet level dropped to 20 x 109/L. Management of thrombocytopenia included multiple platelet transfusion. Cranial ultrasound on day one of life showed bilateral subependymal hemorrhage with cysts (A) and hydrocephaly (B), signs of prenatal occurrence. Platelet phenotypage rules out the diagnosis of allo-immune thrombocytopenia. Laboratory testing for rubella was negative. Blood PCR CMV was positive. Liver function tests noted the absence of hepatic cytolysis and cholestasis. The newborn received intravenous Ganciclovir® therapy. Hearing screening before discharge was negative. Bilateral deafness was diagnosed at 3 months of life.Pan African Medical Journal 2015; 2

Amniotic amputation

Amniotic band syndrome (ABS) is an uncommon, congenital fetal abnormality. Lower extremity limb defects are the common manifestations of ABS. The most common features include congenital distal ring constrictions, intrauterine amputations, and acrosyndactyly. Rare cases of craniofacial and visceral defects were reported. A female newborn, born at 33 weeks of gestation from a 43 years-old mother, gravida 6 para 6. The newborn was eutrophic (birth weight was 2500g, length was 46 cm and head circumference was 31 cm). Pregnancy was uneventful. Prenatal ultrasonography follow-up showed no abnormalities. Postnatal examination showed signs consistent with the diagnosis of amniotic bands syndrome at the newborn's left limbs. The newborn presented syndactyly, lymphedema, with distal agenesis of the 2nd, 3rd, and 4th fingers; ring constrictions of the great toe, and distal agenesis of the 2nd toe. No other birth defect was associated. The newborn was discharged on the tenth day of life. He was referred for orthopedic management of these anomalies.Pan African Medical Journal 2015; 2

Isolated anti-Ro/SSA thrombocytopenia: a rare feature of neonatal lupus

We report a rare case of isolated thrombocytopenia related to anti-Ro/SSA antibodies. The mother was  followed for unlabeled familial thrombocytopenia. The mother had positive anti-Ro/SSA antibodies. She was asymptomatic without skin lesions or other criteria neither of systemic lupus erythematosus nor other  connective tissue disease. Pregnancy was uneventful. The postnatal examination was normal. On the first day of life, blood cells count showed thrombocytopenia at 40 x 109/L. Within the second day of life, platelet level  dropped to 20 x 109/L. The management of thrombocytopenia included platelet transfusion and human  immunoglobulin infusion. On the fifth day of life, there has been a drop in platelet count to 10 x 109/L requiring renewed platelet transfusion and human immunoglobulin infusion. On the 10th of life platelets rate was stable around 60 x 109/L. The infant had no evidence of cardiac, dermatologic or hepatobilary involvement initially or throughout follow up.Key words: Neonatal lupus erythematosus, thrombocytopenia, anti-Ro/SS

Perinatal lethal type II osteogenesis imperfecta: a case report

We report a new case of osteogenesis imperfecta (OI) type II which is a perinatal lethal form. First trimester ultrasound didn't identified abnormalities. Second trimester ultrasound showed incurved limbs, narrow chest, with hypomineralization and multiple fractures of ribs and longbones. Parents refused pregnancy termination; they felt that the diagnosis was late. At birth, the newborn presented immediate respiratory distress. Postnatal examination and bone radiography confirmed the diagnosis of OI type IIA. Death occurred on day 25 of life related to respiratory failure.Key words: Osteogenesis imperfecta, newborn,prenatal diagnosi

Acute neonatal appendicitis in a preterm

Acute neonatal appendicitis is very rare in the neonatal period. It is usually associated with comorbidity including prematurity. Symptoms are non-specific. The prognosis is marked by high risk of mortality and morbidity. Here, we report a case of preterm new born who presented with sepsis, apnoea, and digestive signs. The laparotomy revealed perforated appendicitis complicated with peritonitis

Fetal cyst reveling retroperitoneal enteric duplication

Retroperitoneum is a very uncommon site of enteric duplication (ED). We report a new case of retroperitoneal ED cyst suspected in utero. Prenatal ultrasound showed an abdominal cystic mass. Noncommunicating retroperitoneal ED cyst measuring 70 mm × 30 mm was resected. Histopathologic examination confirmed the diagnosis