Fetus

Fetus Removed From Brain of 1-Year-Old Girl

Posted by

0


Intracranial fetus-in-fetu identified in child with motor delay

MRI images of the fetus inside the infant’s skull next to photos of the fetus removed.Intraventricular Fetus-in-Fetu With Extensive De Novo Gain in Genetic Copy Number. Wolters Kluwer Health, Inc.

A very rare intraventricular fetus-in-fetu was surgically removed from a 1-year-old girl with motor delay and an enlarged head circumference, a report from China showed.

The fetiform mass was a malformed monochorionic diamniotic twin, reported Chunde Li, MD, of Beijing Tiantan Hospital, and co-authors in Neurologyopens in a new tab or window.

Genetic sequencing showed identical single-nucleotide variants in the host child and fetus-in-fetu, with the fetus-in-fetu having extensive de novo copy number gains. The extensive de novo copy-number gains suggested the significance of copy-number variation during embryogenesis, the researchers noted.

“The intracranial fetus-in-fetu is proposed to arise from unseparated blastocysts,” Li and colleagues wrote. “The conjoined parts develop into the forebrain of host fetus and envelop the other embryo during neural plate folding.”

Fetus-in-fetu is a rare anomaly in which a vertebrate fetiform mass is found inside the body of a twin. It occurs in roughly one in 500,000 live births, often in the retroperitoneumopens in a new tab or window of infants. A case of a fetus growing inside the abdomen of a young boy was described as early as 1808opens in a new tab or window.

About 200 fetus-in-fetu cases have been reported in the literature, but very few have been intracranialopens in a new tab or window.

Fetus-in-fetu cases can be misdiagnosed as teratomas. “Fetus-in-fetu can be distinguished from teratomas based on the younger age of presenting patients and the presence of vertebrae or internal organs,” Li and co-authors noted.

In this case report, a 1-year-old girl presented with motor delay; she was unable to sit independently. On examination, she had an enlarged head circumference of 56.5 cm. She had no sign of intracranial hypertension (nausea, vomiting, irritability, or deviated downward eyes) and exhibited full range of motion in four extremities with normal muscle tone.

Head CT and MRI revealed that the infant girl had hydrocephalus, a compressed brain, and an intraventricular fetiform mass. The mass had a vertebral column, femur, and tibia. Imaging showed the fetus-in-fetu had spina bifida; when further examined, it also had upper limbs and finger-like buds.

Intracranial cases reported in recent years include a fetus-in-fetu with well-developed organsopens in a new tab or window in Thailand and one that was removed from a 5-year-old childopens in a new tab or window in India. Fetus-in-fetu has developed in other unusual parts of the body, including the scrotal sac of an infantopens in a new tab or window boy.

Woman with stomach pain found to have ‘lithopedion’ a 40-year-old FOETUS inside.

Posted by

0


  • The 82-year-old, from Bogota, had what is known as ‘lithopedion’
  • Also called a ‘stone baby’, it’s when the fetus develops outside the womb
  • The woman will now will undergo surgery to have the fetus – mostly comprised of dead tissue – removed

A Colombian woman suffering from stomach pain was found to have a 40-year-old fetus inside her.

The 82-year-old, from Bogota, had what is known as ‘lithopedion’, or stone baby, when the unborn child develops outside the womb.

The woman was originally thought to be suffering from a stomach bug,

An 82-year-old Colombian woman suffering from stomach pain was found to have a 40-year-old foetus inside herA Colombian woman suffering from stomach pain was found to have a 40-year-old fetus inside her

But an scans revealed lithopedion, where the fetus becomes calcified.There are fewer than 300 cases reported in medical literature.

The woman will now will undergo surgery to have the fetus – mostly comprised of dead tissue – removed.

 According to NTD, Dr Kemer Ramirez of Bogota’s Tunjuelito Hospital said that the doctor overseeing the woman noticed something ‘abnormal in her abdomen‘ – and suspected gallstones.

An ultrasound showed nothing then radiography of her abdomen revealed a tumour in her abdominal cavity.

Dr Ramirez explained: ‘This happens because the fetus does not develop in the uterus because it has moved to another place.

Dr Kemer Ramirez of Bogota's Tunjuelito Hospital (pictured)Dr Kemer Ramirez of Bogota’s Tunjuelito Hospital (pictured) explained the woman was suffering from ‘lithopedion’, or stone baby, when the unborn child develops outside the womb

‘In this case, the abdominal part of the woman is not a viable (place) and this is what happened, a calcified fetus because the body is generating defence mechanisms and it is calcified until it stays there encapsulated.’

The patient is thought to have been transferred to another hospital to have the lithopedion removed.

In 2009, a 92-year-old Chinese woman was found to have a 60-year-old ‘stone baby’ inside her.

The first reported case of lithopedion was Madame Colombe Chatri, a 68-year-old French woman.

An autopsy after her death in 1582 revealed she had been carrying a fully-developed stone baby in her abdominal cavity for 28 years.

Babies can learn their first lullabies in the womb.

Posted by

0


An infant can recognise a lullaby heard in the womb for several months after birth, potentially supporting later speech development. This is indicated in a new study at the University of Helsinki.

The study focused on 24 women during the final trimester of their pregnancies. Half of the women played the melody of Twinkle Twinkle Little Star to their fetuses five days a week for the final stages of their pregnancies. The brains of the babies who heard the melody in utero reacted more strongly to the familiar melody both immediately and four months after birth when compared with the control group. These results show that fetuses can recognise and remember sounds from the outside world.

This is significant for the early rehabilitation, since rehabilitation aims at long-term changes in the brain.

“Even though our earlier research indicated that fetuses could learn minor details of speech, we did not know how long they could retain the information. These results show that babies are capable of learning at a very young age, and that the effects of the learning remain apparent in the brain for a long time,” expounds Eino Partanen, who is currently finishing his dissertation at the Cognitive Brain Research Unit.

“This is the first study to track how long fetal memories remain in the brain. The results are significant, as studying the responses in the brain let us focus on the foundations of fetal memory. The early mechanisms of memory are currently unknown,” points out Dr Minna Huotilainen, principal investigator.

The researchers believe that song and speech are most beneficial for the fetus in terms of speech development. According to the current understanding, the processing of singing and speech in the babies brains are partly based on shared mechanisms, and so hearing a song can support a baby’s speech development. However, little is known about the possible detrimental effects that noise in the workplace can cause to a fetus during the final trimester. An extensive research project on this topic is underway at the Finnish Institute of Occupational Health.

The study was published by the esteemed American scientific journal PLoS ONE. The research was conducted at the Academy of Finland’s Finnish Centre of Excellence in Interdisciplinary Music Research as well as the Cognitive Brain Research Unit at the University of Helsinki Institute of Behavioural Sciences.

Percutaneous vesicoamniotic shunting versus conservative management for fetal lower urinary tract obstruction (PLUTO): a randomised trial.

Posted by

0


Summary

Background

Fetal lower urinary tract obstruction (LUTO) is associated with high perinatal and long-term childhood mortality and morbidity. We aimed to assess the effectiveness of vesicoamniotic shunting for treatment of LUTO.

Methods

In a randomised trial in the UK, Ireland, and the Netherlands, women whose pregnancies with a male fetus were complicated by isolated LUTO were randomly assigned by a central telephone and web-based randomisation service to receive either the intervention (placement of vesicoamniotic shunt) or conservative management. Allocation could not be masked from clinicians or participants because of the invasive nature of the intervention. Diagnosis was by prenatal ultrasound. The primary outcome was survival of the baby to 28 days postnatally. All primary analyses were done on an intention-to-treat basis, but these results were compared with those of an as-treated analysis to investigate the effect of a fairly large proportion of crossovers. We used Bayesian methods to estimate the posterior probability distribution of the effectiveness of vesicoamniotic shunting at 28 days. The study is registered with the ISRCTN Register, number ISRCTN53328556.

Findings

31 women with singleton pregnancies complicated by LUTO were included in the trial and main analysis, with 16 allocated to the vesicoamniotic shunt group and 15 to the conservative management group. The study closed early because of poor recruitment. There were 12 livebirths in each group. In the vesicoamniotic shunt group one intrauterine death occurred and three pregnancies were terminated. In the conservative management group one intrauterine death occurred and two pregnancies were terminated. Of the 16 pregnancies randomly assigned to vesicoamniotic shunting, eight neonates survived to 28 days, compared with four from the 15 pregnancies assigned to conservative management (intention-to-treat relative risk [RR] 1·88, 95% CI 0·71—4·96; p=0·27). Analysis based on treatment received showed a larger effect (3·20, 1·06—9·62; p=0·03). All 12 deaths were caused by pulmonary hypoplasia in the early neonatal period. Sensitivity analysis in which non-treatment-related terminations of pregnancy were excluded made some slight changes to point estimates only. Bayesian analysis in which the trial data were combined with elicited priors from experts suggested an 86% probability that vesicoamniotic shunting increased survival at 28 days and a 25% probability that it had a large, clinically important effect (defined as a relative increase of 55% or more in the proportion of neonates who survived). There was substantial short-term and long-term morbidity in both groups, including poor renal function—only two babies (both in the shunt group) survived to 2 years with normal renal function. Seven complications occurred in six fetuses from the shunt group, including spontaneous ruptured membranes, shunt blockage, and dislodgement. These complications resulted in four pregnancy losses.

Interpretation

Survival seemed to be higher in the fetuses receiving vesicoamniotic shunting, but the size and direction of the effect remained uncertain, such that benefit could not be conclusively proven. Our results suggest that the chance of newborn babies surviving with normal renal function is very low irrespective of whether or not vesicoamniotic shunting is done.

Source: Lancet

FDA Warns Against Prolonged Use of Magnesium Sulfate to Stop Preterm Labor.

Posted by

0


The FDA is changing the label of magnesium sulfate to warn against its use for more than 5 to 7 days to stop preterm labor. Long-term use can lead to hypocalcemia, osteopenia, and fractures in the infant. In addition, the drug’s pregnancy category is being changed from A to D, indicating “positive evidence of human fetal risk.”

The FDA reemphasizes that magnesium sulfate is not approved to stop preterm labor. It is unknown whether a shorter treatment duration would result in harm to the fetus.

The warning comes after the FDA reviewed epidemiologic data and 18 cases of skeletal abnormalities in infants exposed to magnesium sulfate in utero (average duration of exposure, 10 weeks). The epidemiologic data indicate that laboratory results normalize within days of birth, but long-term clinical effects on bone health aren’t known.

Asked to comment, Allison Bryant of Journal Watch Women’s Healthwrote: “The use of magnesium sulfate as a tocolytic persists in many institutions. In addition, data suggesting its effectiveness in providing neuroprotection for fetuses exposed in utero and born at early gestational ages have led to a resurgence in use. However, there are no data suggesting value to using magnesium sulfate for tocolysis for longer than 48 hours, for neuroprotection beyond when delivery is felt to be imminent, or for seizure prophylaxis in the setting of preeclampsia beyond 24 hours postpartum. Therefore, this FDA warning is unlikely to greatly alter current clinical practice.”

Source: FDA