P26Congenital Rubella syndrome and fetal exencephaly – case report

Abstract

Exencephaly is characterized by a complete or partial absence of the skull'cap, follwed by abnormal development of the cerebral tissue.We report a case of a 31‐year‐old, white patient, on the 9th. week of her second gestation who presented with fever, coryza and myalgia. The gestational period was calculated based on the first ultrasonography, and the maternal sorology for rubella was positive (IgG and IgM).The patient was send to the department of Fetal Medicine‐HCFMUSP for evaluation. Morphologic ultrasonography and another sorology for rubella were performed. On the 12th gestation week, ultrasonography revealed absence of the skullcap and the presence of cerebral tissue floating in the amniotic fluid. Maternal sorology still showed positive (IgG and IgM). The patient suffered a miscarriage and the maternal (fetus and placenta) was analyzed at the Virology Department of Adolfo Lutz Institute. The virus of rubella was isolated in all the examined organs, and the presence of congenital rubella was confirmed.Considering that the etiology of this malformation is still umknown and is associated with a severe congenital infection we speculate that is coul be a consequence of the massive fetal compromise caused by the rubella virus.