![]() ![]() Gastrulation occuring in the embryonic period converts the bilaminar embryonic disc to a trilaminar structure containing ecto-, endo-, and mesoderm. The English literature contains only few cases of vertebral malformation which were diagnosed prenatally. 1, 3 In our case, the affected fetus was female, and this is in agreement with the described higher incidence for females compared with males. births, with a male to female ratio of 0.31 for multiple vertebral anomalies and 0.68 for solitary vertebral anomalies. The incidence of hemivertebra is estimated at 0.5–1. No other skeletal anomalies of the spine, ribs, and limbs, or cardiac, renal, and gastrointestinal anomalies were found. A 500 g stillborn female neonate was delivered with obvious deformation of the spine ( Figure 3), and the ultrasonographic findings were confirmed with a simple X-ray of the stillborn fetus ( Figures 4 and and5) 5) and with pathologic examination. ![]() The initial diagnosis was single hemivertebra, and the parents opted for termination of pregnancy. The overlying skin appeared intact and there were no intercranial findings suggestive of an open neural tube defect. A small triangular bony structure was wedged against the normal vertebral bodies ( Figures 1 and and2). However, a distortion at the lumbar region of the spine was demonstrated in the longitudinal plane. At the routine ultrasonographic anatomy scan of the fetus at 20 weeks’ gestation, the biparietal diameter was 46 mm, the abdominal circumference 145 mm, the fetal femur length 32 mm, and estimated fetal weight 348 g. No malformations were detected during ultrasound scanning at the sixteenth week of gestation. The triple test at 16 weeks’ gestation was negative, ie, alpha-fetoprotein 42 ng/mL (multiples of the mean = 0.992), estriol 3.8 nmol/L (MoM = 1.834), free beta- human chorionic gonadotropin 28 ng/mL (MoM = 2.806). The patient was a 26-year-old woman, gravida 1 para 0, with an unremarkable medical history. ![]()
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