An unusual constellation of sonographic findings associated with congenital syphilis

Article Abstract:

Congenital syphilis is an inherited form of syphilis that is passed from an infected pregnant woman to the developing fetus. Over the last several years, the incidence of syphilis among young men and women of childbearing age has increased, and this has resulted in an increase in the incidence of congenital syphilis. In New York City, the number of reported cases of congenital syphilis was six times higher in 1988 than it was in 1986. It has been suggested that the exchange of sex for drugs is partially responsible for the increased number of cases of syphilis. When the developing fetus becomes infected with Treponema pallidum, the organism responsible for syphilis, the spleen and liver become abnormally large (hepatosplenomegaly) and inflammation occurs in bone and cartilage (osteochondritis). This article describes the results of a fetal ultrasound examination performed on a 30-year-old pregnant woman with syphilis. Fetal measurements obtained by the ultrasound were consistent with a fetus 23.5 weeks old, and revealed an abnormally large abdomen and thick placenta. The intestines were dilated and the stomach was distended. Ten days after the ultrasound, the woman gave birth to a stillborn male infant. An autopsy was performed on the infant, who was found to have hepatosplenomegaly, obstructed intestines, and T. pallidum present in the liver, stomach, intestines, spleen, lymph nodes and central nervous system. Based on these findings it is suggested that symptoms of hepatosplenomegaly, a thick placenta and blocked intestines may indicate the presence of congenital syphilis. (Consumer Summary produced by Reliance Medical Information, Inc.)

Ultrasound imaging, Syphilis, Congenital, hereditary, and infantile, Congenital syphilis

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Pregnancy and liver transplantation

Article Abstract:

The results of a retrospective study are presented involving eight pregnant women who were also liver transplant recipients. Seven became pregnant after transplantation (conceptions ranged from 3 weeks to 24 months after transplant), and one required transplantation in the 27th gestational week as a result of fulminant hepatitis B. Six of the seven had live births, of which one died; one chose to terminate her pregnancy. The other five were doing well at the time of the report. All developed high blood pressure during pregnancy, and three developed severe preeclampsia (a condition of high blood pressure, protein in the urine, and edema), necessitating premature delivery. The patient who underwent transplantation during pregnancy required a second transplanted liver three days later, which functioned well. However, the patient developed kidney failure, and the fetal heart became abnormal; a cesarean section was performed, but the infant died four days after birth. All eight patients were alive when the report was written. A discussion and literature review are presented concerning pregnancy in women who are transplant recipients. Such patients have a heightened risk for preeclampsia, pregnancy-induced hypertension, and premature delivery. They do not, however, seem to have a greater risk of graft rejection. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Complications and side effects, Liver, Liver transplantation, Transplantation of organs, tissues, etc., Organ transplantation, Tissue transplantation, Transplantation, Pregnancy, Complications of, Pregnancy complications

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A sonographic and karyotypic study of second-trimester fetal choroid plexus cysts

Article Abstract:

Choroid plexus cysts, abnormal growths in the blood vessels of the innermost membrane covering the brain and spinal cord, were examined in a sonography and chromosome study of 513 pregnant women. The presence or absence of the cysts was noted and the results correlated with a study of the full chromosome set of the cells' nuclei (fetal karyotype). Ultrasound detected 13 cases of choroid plexus cysts, which averaged 6 mm in size. Ultrasound did not detect any other abnormalities, and the fetal karyotype was normal in all 13 of the cases. No association was seen between fetal choroid plexus cysts and chromosome abnormalities (autosomal trisomies) in this study.

Evaluation, Causes of, Trisomy, Brain diseases, Cysts, Fetal diseases, Diagnosis, Ultrasonic, Diagnostic ultrasonography

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