Acrania is a rare lethal congenital anomaly in which there is partial or complete absence of the fetal scalp bones (calvarium). The brain tissue is completely but abnormally developed.
We present a 22-year-old primigravida, an unmarried
secondary school drop-out who presented for prenatal care at 31 weeks of
gestation and developed pre-term prelabor rupture of membranes a week later. An
obstetric scan at the presentation revealed acrania of the fetus and she was
offered medical termination of the pregnancy which was declined insisting on
awaiting fetal maturity. She was managed conservatively until 34 weeks of
gestation when she had a lower segment caesarean section. The Outcome was a live
1.8kg female fetus with acrania and other malformations who suffered an Early
Neonatal Death.
Early antenatal booking with a booking scan as early as 10
weeks would have enabled an early diagnosis of this very rare and lethal
congenital malformation and would have allowed for adequate counselling and
planning including medical termination of the pregnancy at an early gestational
age when it would have been more acceptable. The patient was exposed to
avoidable pregnancy morbidity and its sequelae for a fetus unlikely to survive
beyond the neonatal period.
Author(s) Details:
Okagua, Kenneth Eghuan,
Department of Obstetrics and Gynaecology, Rivers State University Teaching Hospital, Nigeria.
Okagua, Joyce,
Department of Paediatrics, University of Port Harcourt Teaching Hospital, Nigeria.
Eli, Sukarime,
Department of Obstetrics and Gynaecology, Rivers State University Teaching Hospital, Nigeria.
Please see the link here: https://stm.bookpi.org/NVMMS-V2/article/view/13796
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