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Limb‐body wall defect: Experience of a reference service of fetal medicine from Southern Brazil
Authors:Ana C Gazolla  André C da Cunha  Jorge AB Telles  Rosilene da S Betat  Mayara A Romano  Isabel Marshall  Amanda M Gobatto  Anna M de H Bicca  Camila P Arcolini  Thaís KV Dal Pai  Luciane R Vieira  Luciano V Targa  Ildo Betineli  Paulo RG Zen  Rafael FM Rosa
Institution:1. Ginecology and Obstetrics, Hospital Materno Infantil Presidente Vargas (HMIPV), Porto Alegre, RS, Brazil;2. Fetal Medicine, HMIPV, Porto Alegre, RS, Brazil;3. Pediatrics and Neonatology, HMIPV, Porto Alegre, RS, Brazil;4. Graduation in Medicine, Universidade Luterana do Brasil (ULBRA), Canoas, RS, Brazil;5. Pediatric Cardiology, HMIPV, Porto Alegre, RS, Brazil;6. Radiology, HMIPV, Porto Alegre, RS, Brazil;7. Tomoclínica, Canoas, RS, Brazil;8. Clinical Genetics, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) and Complexo Hospitalar Santa Casa de Porto Alegre (CHSCPA), Porto Alegre, RS, Brazil;9. Graduate Program in Pathology, UFCSPA, Porto Alegre, RS, Brazil;10. Clinical Genetics, HMIPV, Porto Alegre, RS, Brazil
Abstract:Background: Limb‐body wall defect is a rare condition characterized by a combination of large and complex defects of the ventral thorax and abdominal wall with craniofacial and limb anomalies. Methods: The aim of this study was to describe the experience of our fetal medicine service, a reference from Southern Brazil, with prenatally diagnosed patients with a limb‐body wall defect in a 3 years period. Only patients who fulfilled the criteria suggested by Hunter et al. (2011) were included in the study. Clinical data and results of radiological and cytogenetic evaluation were collected from their medical records. Results: Our sample was composed of 8 patients. Many of their mothers were younger than 25 years (50%) and in their first pregnancy (62.5%). It is noteworthy that one patient was referred due to suspected anencephaly and another due to a twin pregnancy with an embryonic sac. Craniofacial defects were verified in three patients (37.5%), thoracic/abdominal abnormalities in 6 (75%) and limb defects in eight (100%). Congenital heart defects were observed in five patients (62.5%). One of them presented a previously undescribed complex heart defect. Conclusion: The results disclosed that complementary exams, such as MRI and echocardiography, are important to better define the observed defects. Some of them, such as congenital heart defects, may be more common than previously reported. This definition is essential for the proper management of the pregnancy and genetic counseling of the family. The birth of these children must be planned with caution and for the prognosis a long survival possibility, despite unlikely and rare, must be considered. Birth Defects Research (Part A) 100:739–749, 2014. © 2014 Wiley Periodicals, Inc.
Keywords:limb‐body wall defect  amniotic bands  congenital heart defects  acrania  twin  ultrasound  magnetic resonance imaging  survival
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