Abstract
Primary infertility led to conception by in vitro fertilisation. Anomaly scan revealed upper limb defects. After termination of pregnancy, post mortem found radial ray defects and facial dysmorphism. Fetal chromosomal analysis, parental karyotyping and genetic studies were normal. Difficulty in this case lay with determining a definitive diagnosis which has implications on recurrence and counselling. Nager syndrome is the closest possible diagnosis. This case shows that it is essential for obstetricians to have good communication and counselling skills. A multidisciplinary team approach is important including the fetomaternal specialist, geneticist and pathologist.
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