Intrauterine Fetal Growth Restriction and Oligohydramnios of Undetermined Etiology.

Abstract

A 32-year-old G3P2002 (3 pregnancies, 2 births at full term, 0 preterm, 0 abortions, 2 still living) pregnant woman of Filipino ancestry was referred to a tertiary institution for severe intrauterine growth restriction (IUGR)4 at 20 weeks' gestation. Ultrasound showed fetal size uniformly less than expected, with measurements <1% for age, small chest, echogenic bowel, thickened nuchal fold, enlarged cisterna magna, and severe oligohydramnios. The obstetric history was relevant for 2 healthy children with a different partner. The healthy Filipino father of the current pregnancy also had 2 healthy children with a different partner. There was no relevant medication or drug history, and thyroid function tests were normal. The patient was Rh-positive, with negative antibody screen and negative cystic fibrosis carrier screen. Maternal serum quad screen (α-fetoprotein, estriol, human chorionic gonadotropin, and inhibin A) for fetal aneuploidy indicated low risk. Maternal complete blood count included a hematocrit of 33%, hemoglobin of 10.8 g/dL (reference range 11.5–15.5), and mean corpuscular volume of 60 fL (reference range 81–98). Prenatal records indicated that the father of this pregnancy had normal complete blood count values, although the original test results were not available. Diagnostic amniocentesis showed that amniotic fluid α-fetoprotein was normal for gestational age, and PCR for cytomegalovirus (CMV) and toxoplasmosis was negative. Interphase …