Educational case of the issue

Abstract

A 23-year-old lady was referred for routine antenatal ultrasound (US) scan. Her blood group was AB +ve. Her blood sugar was normal and she was negative for TORCH titers. US features were consistent with the diagnosis of hydrops in a 17 weeks fetus. Fetal echocardiography revealed an echogenic cardiac focus and fetal Doppler velocimetry was normal. Ultrasound examination revealed a 17 weeks fetus which had scalp and subcutaneous edema with an avascular sac behind the neck which was suggestive of a cystic hygroma (Fig. 1). In addition, there was abdominal wall edema, a small left pleural effusion, abnormal cardiac focus and echogenic bowel (Fig. 2). This echogenic focus, echogenic cardiac bowel and cystic hygroma in the fetus pointed towards a fetal chromosomal anomaly as the cause of hydrops. The couple was counseled and advised amniocentesis but they did not give consent for it and instead opted for termination of pregnancy without further investigations. The little finger of the fetus was taken for the fetal karyotype which revealed Trisomy 21 in the fetus. Fig. 3 shows the abortus [1].