Colon cancer in pregnancy with elevated maternal serum alpha-fetoprotein level at presentation

Article Abstract:

Alpha-fetoprotein (AFP) is a protein found in the blood of pregnant women, and elevated levels of AFP are associated with fetal disturbances or chromosomal defects. However, diseases not related to pregnancy may also lead to elevated AFP levels, and this may be used by an aware obstetrician or health practitioner to suspect the presence of other diseases during pregnancy. A case is described of a 33-year-old woman in whom the first sign of colon cancer was an abnormal AFP blood level. The woman had no apparent complications until 16 weeks, when AFP levels were six times higher than average values. Follow-up of this information with ultrasound examination and chromosome analysis showed no abnormalities, and the level of AFP in the amniotic fluid surrounding the fetus was normal. The patient developed abdominal pain at 23 weeks, and ultrasound showed an enlarged liver. Further tests suggested that the liver cancer developed as a metastasis from a gastrointestinal cancer. The patient's condition worsened, and a large mass in the colon was found. The patient became lethargic and suffered loss of appetite, and fetal death occurred at 26 weeks; labor was induced successfully. The patient developed systemic infection and other complications, and died two weeks after labor induction. Autopsy showed that 95 percent of liver cells had been replaced by tumorous ones. Colon cancer may be difficult to diagnose in pregnant women, as symptoms such as constipation or abdominal pain are common in early pregnancy. Although colon cancer in pregnancy is thought to occur in 1 out of 50,000 to 100,000 pregnant women, the incidence may rise with the age of the women. Attention to elevated maternal but not amniotic AFP levels may aid in diagnosis of the condition. (Consumer Summary produced by Reliance Medical Information, Inc.)

Measurement, Colorectal cancer, Pregnancy, Complications of, Pregnancy complications, Alpha fetoproteins

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Prenatal diagnosis of a chest wall mass with ultrasonography and Doppler velocimetry

Article Abstract:

Ultrasonography is a diagnostic technique in which sound waves are used to visualize internal body structures. This imaging technique is frequently utilized to examine the fetus for abnormalities during pregnancy. With ultrasonography, tumors within the chest wall of the fetus have been diagnosed before birth. However, the detection of tumors on the outside of the chest wall of the fetus using ultrasonographic techniques has not previously been reported. A modified ultrasonographic method called Doppler velocimetry is used to assess blood flow, and can distinguish between different types of tumors based on blood flow characteristics. A case is described of a male infant with a growth on the outside of the right chest wall, which was detected by ultrasonography before birth. Doppler ultrasonography showed that the tumor had a low-resistance blood flow, which is characteristic of a hemangioma, a benign tumor of blood vessels that are dilated. The infant was delivered by cesarean section at 35 weeks gestation, to reduce the risk that the mass would rupture. On the fifth day after birth, the mass was removed. Examination of the tumor confirmed that the mass was a hemangioma. The infant was discharged two days after the operation and was doing well at follow-up at six months of age. It is interesting to note that the baby's father had a similar right chest wall mass diagnosed at birth and removed at the age of six years. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Diagnosis, Doppler ultrasonography, Hemangioma, Prenatal diagnosis

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Superior mesenteric artery Doppler velocimetry and ultrasonographic assessment of fetal bowel in gastroschisis: a prospective longitudinal study

Article Abstract:

The need for surgery and an extended hospital stay for fetuses with gastroschisis may be predicted by a dilated bowel diameter between 28 and 32 weeks of pregnancy. Gastroschisis is a defect in the fetal abdominal wall that allows abdominal contents to protrude. Researchers found that the superior mesenteric artery pulsatility index was below normal in eight of 16 fetuses with gastroschisis, but it did not predict good or poor outcome. The best predictor of the need for extensive surgery and hospitalization was a bowel diameter over 10 mm at 28 to 32 weeks' gestation.

Intestines

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