HISTORY: 27 y.o. G6 P1132 (SAB 3) at 13 weeks referred for a cyst in the fetal abdomen.

Here are some of the images obtained:

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This is a 27 yr old G2P1 at 20 5/7 weeks. She was referred for evaluation because of a second trimester ‘quad’ screen which identified an increased risk for open neural tube defects. The results of the ‘quad’ screen are as follows:

Down syndrome risk	1:1121
Trisomy	1:3473
ONTD	1:10

The individual analyte levels are:

AFP8	8.73 MOM
Hcg	4.26 MOM
DIA	2.95 MOM
uE3	0.58 MOM

Selected images from the 20 week ultrasound are given below. Overall fetal biometry was appropriate for gestational age with an AUA of 20 wks 1 day.

In addition to ultrasound, amniocentesis was performed. Fluid results include:

AFAFP	4.00 MOM
AChE	negative
Fetal karyotype	46 XX

Further testing performed on the fluid will be discussed when the answer is revealed next week. Good luck

 

Here are some of the images obtained:

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Images at 18 Weeks:

Images at 26 Weeks:

Before deciding the answer, please review images from the next exams on this patient which I intentionally withheld:

30 weeks: 32 weeks:
35 weeks:36 weeks:
Now with oligohydramnios, AFI of 7 which decreased to 5.8 by 36 weeks 6 days, when the fetus was delivered

 

 

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