Facial Teratoma in the Newborn: Diagnosis and Prognosis

Facial teratoma is an extremely rare germinal tumor in newborn babies. It is often diagnosed antenatally by means of ultrasound and even MRI. The prognosis of this tumor depends mainly on the size and the location of the lesion (eye, respiratory and digestive tracts). Multidisciplinary examination is needed to ensure the newborn’s survival. Pre-operative conditioning is needed to avoid complications and carcinogenic risks. The aim of this article is to Specify the anatomical features of facial teratoma and consider the interests of foetopathology review. We report a male baby, prematurely born at 28 WA dead at hour 23. Physical examination reveals a frontal mass on the left side of the face plus a facial dysmorphia. Dissection shows hyperplasia of lungs, hypertrophied liver and a splenomegaly. Histological examination reveals neural tissue associated with areas of cartilage and hair; hence the diagnosis of congenital teratoma of the face. Antenatal diagnosis of congenital teratoma of the face is very crucial allowing a multidisciplinary care involving obstetricians, neonatologists, surgeons and anesthesiologists

Ultrasound cervical length in predicting preterm birth

BackgroundPreterm birth is a leading cause of perinatal morbidity and mortality and represents a major public health problem. It is associated with a 15–20 per cent mortality rate and remains responsible for 75 per cent of perinatal deaths in foetuses without anomalies.AimsThe aim of this study was to evaluate the importance of cervical length measured in the first trimester (11–14 Weeks of amenorrhea “WA”) and the second trimester (20–24 Weeks of amenorrhea” WA”) in an asymptomatic population of singleton pregnancies to assess the risk of spontaneous preterm birth compared to the digital assessment.Methods We conducted a prospective, longitudinal study involving 117 asymptomatic women with singleton pregnancies between January and December 2015.Results In our study, the clinical examination had a low positive predictive value and a low sensibility for screening women at risk of preterm delivery. Cervical length less than 35mm between 12–14WA and 30mm between 22–24WA predicts the occurrence of preterm birth with a high sensitivity (Se), and specificity (Sp).ConclusionWe conclude that ultrasound screening of preterm delivery is now highly recommended

Corpus callosum agenesis: Role of fetal magnetic resonance imaging

Corpus callosum agenesis (CCA) was evaluated by ultrasound examination and magnetic resonance imaging (MRI) with many studies. Ultrasonography was able to suspect CCA by indirect signs but a definitive diagnosis of CCA was achieved in rare cases. MRI was able to diagnose complete CCA in majority of cases. Additional neurological abnormalities including heterotopia, gyration anomaly, asymmetry of the cerebral hemispheres, and Dandy-Walker variant were documented, as well as an ocular anomaly which was described, by MRI examination. Prenatal counseling for fetal agenesis of the corpus callosum is difficult as the prognosis is uncertain. The association with other cerebral abnormalities increases the likelihood of a poor outcome and ultrasonographic assessment of the fetal brain is limited. We found MRI to be a safe and useful additional procedure to complement ultrasonographic diagnosis or suspicion of CCA

Diagnostic and decision-making difficulties: Placenta accreta at nine weeks' gestation

The majority of cases of placenta accreta are unanticipated and initially identified intraoperatively. Although color Doppler ultrasound is adequate for the evaluation of placenta accreta in the third trimester, ultrasound diagnosis in the first trimester has never been reported. To our knowledge, this is the first case of placenta accreta detected at 9 weeks' gestation by ultrasound. Placenta accreta with intraplacental lacunae can be identified together with a loss of the hypoechogenic retroplacental myometrial zone. Based on this case, we found that early diagnosis of placenta accreta in the first trimester by ultrasound is possible

Spontaneous acute intussusception in a pregnant woman

Acute intussusception in adults is rare and particularly so in pregnant women. Its incidence ranges from 0.067% to 0.0015% (Choi et al., 2005 Choi et al. (2005) [1]). The non-specific presenting symptoms may be attributed to the pregnancy itself, making the diagnosis difficult. When it happens, however, it causes considerable morbidity and mortality for the pregnant woman and the fetus. In adults, such intussusceptions are mainly secondary to an intestinal disease and frequently a tumor. We present the case of a 21-year-old pregnant woman who was diagnosed of spontaneous acute intussusception at nine weeks of gestation and therapeutic management

Twin pregnancy with both complete hydatiform mole and coexistent alive fetus: Case report

Twin pregnancy consisting of a complete hydatidiform mole coexisting with a live fetus is a rare condition with an incidence of 1 in 22000 to 1 in 100000 pregnancies. Clinical information is limited and management is difficult due to the risk of pregnancy complications such as fetal death, vaginal bleeding, preeclampsia, hyperthyroidism, and the risk of persistent gestational trophoblastic disease. Thus, the report described about the change of size and implantation site of the molar mass coexisting with a live fetus is rare especially about sonographic findings such as echo patterns. Recently we experienced a case of complete hydatidiform mole with a healthy infant delivered at term

Successful pregnancy by IVF in a patient with congenital cervical atresia

Congenital cervical atresia and hypoplasia are rare abnormalities that generally require reconstructive or extirpative procedures to relieve outflow tract obstruction. Infertility is a common sequel, and only four previous pregnancies have been reported. We report a case of successful pregnancy after in-vitro fertilization in a 32-year-old patient with congenital cervical atresia diagnosed at the age of 28 years. She was referred to our unit and had a successful pregnancy after in-vitro fertilization. Caesarean section was performed at 38 weeks gestation. A healthy male baby weighing 3650 g was safely delivered

FIGO opinion paper: Drivers and solutions to the cesarean delivery epidemic with emphasis on the increasing rates in Africa and Southeastern Europe

Cesarean delivery rates are rapidly increasing in Southeastern Europe (to more than 60%), North Africa (with a rate as high as 72% in Egypt), and in urban areas in Southern Africa (a rate of over 50% in Lagos, Nigeria). Data on the background to these increases are scarce, but likely to include poor birthing facilities in general hospitals, convenience for the doctor, private medicine, fear of litigation, socioeconomic status, shortage of midwives and nurses, and disappearance of vaginal instrumental deliveries. Options to reverse cesarean delivery trends are discussed. In this context there is a need to be better informed about how women are being counseled regarding vaginal or cesarean delivery. The long-term consequences in subsequent pregnancies for mothers and children may well be largely ignored, while these risks are highest in LMICs where higher birth numbers are desired. FIGO has begun discussions with obstetric and gynecologic societies, healthcare bodies, and governments in several countries discussed in this article, to find ways to lower the cesarean delivery rate. The requests came from the countries themselves, which may prove beneficial in helping advance progress