August 9th, 2022

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Fetal Spinal Deformity Caused by Uterine Synechiae Mimicking Severe Scoliosis: A Case Report
Authors:  Jin Young Bae, M.D., Hyun Hwa Cha, M.D., and Won Joon Seong, M.D.
BACKGROUND: A severely deformed vertebra is a matter of concern, particularly when it develops before 24 weeks of gestation, which may lead to compromised pulmonary function and neurological development.

CASE: A 39-year-old, nulliparous woman presented at 19 weeks of gestation. Her uterus was snowman shaped due to uterine synechiae, and the fetus was confined in the upper section, where amniotic fluid was scanty. The fetal spine was flexed at the upper thoracic level at an angle greater than 90°, with the head flexed and touching the right shoulder throughout pregnancy. Cesarean section was performed at 29+3 weeks of gestation due to preterm labor. A radiograph acquired immediately postpartum showed only a mild degree of spinal flexion, and during the course of hospitalization for respiratory support the infant’s spine straightened completely. The infant was discharged without any complications.

CONCLUSION: Here, we report an unusual case of severe fetal spinal deformity observed in early fetal life, and the subsequent positive outcome. We therefore advise caution, following a careful evaluation and consultation, before arriving at a decision of termination.
Keywords:  Asherman syndrome, fetal spinal deformity, gynatresia, intrauterine synechiae, pregnancy complications, scoliosis, uterine synechiae
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