Taiwanese Journal of Obstetrics and Gynecology
Volume 45, Issue 2 , Pages 146-149, June 2006

Prenatal Diagnosis of Alobar Holoprosencephaly with Cystic Hygroma

Department of Obstetrics and Gynecology, National Cheng Kung University Medical College and Hospital, Tainan, Taiwan

Accepted 22 November 2005.

Article Outline

Summary 

Objective

Holoprosencephaly is a kind of brain anomaly characterized by inadequate cleavage of the prosencephalon during early embryogenesis. In addition, holoprosencephaly associated with cystic hygroma and hydrops fetalis has never been reported. In this article, we report a rare case of holoprosencephaly associated with cystic hygroma and hydrops fetalis diagnosed prenatally.

Case Report

A 28-year-old woman, gravida 2, para 0, artificial abortion 1, was referred to our antenatal clinic at 16 weeks of gestation due to fetal cystic hygroma detected by prenatal routine ultrasonography at a local hospital. In our clinic, single ventricle with fused thalami and cystic mass at the fetal neck as well as hydrops fetalis were noted by level II ultrasound. Under the impression of holoprosencephaly with cystic hygroma and hydrops fetalis, termination of pregnancy with misoprostol was undertaken. The histopathology of fetal autopsy confirmed our diagnosis and disclosed additional intracranial abnormalities.

Conclusion

Fetus with holoprosencephaly might have other associated structural abnormalities. Cystic hygroma and hydrops fetalis are rare associations. Meticulous sonographic examination to depict the associated defects are necessary in any fetus with holoprosencephaly.

Key Words:  cystic hygroma , holoprosencephaly , prenatal diagnosis

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References 

  1. Kurtz AB , Wapner RJ , Rubin CS , Cole-Beuglet C , Ross D , Goldberg BB . Ultrasound criteria for in utero diagnosis of microcephaly . J Clin Ultrasound . 1980;8:11–16
  2. Cohen MM . Perspectives on holoprosencephaly. Part I. Epidemiology, genetics, and syndromology . Teratology . 1989;40:211–235
  3. Cohen MM . Perspectives on holoprosencephaly. Part III. Spectra, distinctions, continuities, and discontinuities . Am J Med Genet . 1989;34:271–288
  4. Cohen MM . Holoprosencephaly and cytogenetic findings: further information . Am J Med Genet . 1989;34:265
  5. DeMyer W . Holoprosencephaly . In:  Vinken PJ ,  Bruyn GW editor. Handbook of Clinical Neurology . 30: Amsterdam: Elsevier; 1977;p. 431
  6. Matsunaga E , Shiota K . Holoprosencephaly in human embryos: epidemiologic studies of 150 cases . Teratology . 1977;16:261–272
  7. Roach E , DeMyer W , Palmer K , Connelly M , Merritt A . Holoprosencephaly: birth data, genetic and demographic analysis of 30 families . Birth Defect . 1975;11:294–313
  8. Peeble DM . Holoprosencephaly . Prenat Diagn . 1998;18:477–480
  9. Chen C , Liu F , Jan S , Town D , Lan C . Cytogenetic evaluation of cystic hygroma associated with hydrops fetalis, oligohydramnios or intrauterine fetal death: the roles of amniocentesis, postmortem chorionic villus sampling and cystic hygroma paracentesis . Acta Obstet Gynecol Scand . 1996;75:454–458
  10. Sepulveda W , Dezerega V , Be C . First-trimester sonographic diagnosis of holoprosencephaly. Value of the “butterfly sign” . J Ultrasound Med . 2004;23:761–765
  11. Odent S , Le Marec B , Munnich A , Le Merrer M , Bonaiti-Pellie C . Segregation analysis in nonsyndromic holoprosencephaly . Am J Med Genet . 1998;77:139–143

PII: S1028-4559(09)60213-8

doi:10.1016/S1028-4559(09)60213-8

Taiwanese Journal of Obstetrics and Gynecology
Volume 45, Issue 2 , Pages 146-149, June 2006