Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Reverse end-diastolic flow in a fetus with a rare liver malformation: a case report | Giancotti et al. Journal of Medical Case Reports 2011 5 37 http content 5 1 37 JOURNALOF medical case reports CASE REPORT Open Access Reverse end-diastolic flow in a fetus with a rare liver malformation a case report Antonella Giancotti Antonella Spagnuolo Valentina D Ambrosio Gaia Pasquali Brunella Muto Francescantonio Bisogni Renato La Torre Maurizio Marco Anceschi Fabrizio De Gado Abstract Introduction We describe a case of early and persistent reverse end-diastolic flow in the middle cerebral artery in a fetus with severe ascites. These features are associated with a rare liver malformation known as ductal plate malformation. Case presentation A 28-year-old Caucasian woman was referred to our high-risk obstetric unit at 24 weeks gestation for fetal ascites detected during a routine ultrasound examination. During her hospitalization we performed medical investigations including a fetal paracentesis to detect the etiology of fetal ascites. The cause of fetal ascites then considered non-immune or idiopathic was not evident but a subsequent ultrasound examination at 27 weeks gestation showed a reverse end-diastolic flow in the middle cerebral artery without any other Doppler abnormalities. A cesarean section was performed at 28 weeks gestation because of the compromised fetal condition. An autopsy revealed a rare malformation of intrahepatic bile ducts known as ductal plate malformation. Conclusion Persistent reverse flow in the middle cerebral artery should be considered a marker of adverse pregnancy outcome. We recommend careful ultrasound monitoring in the presence of this ultrasonographic sign to exclude any other cause of increased intracranial pressure. To better understand the nature of these ultrasonographic signs additional reports are deemed necessary. In fact in our case as confirmed by histopathological examination the fetal condition was extremely compromised due to failure of the fetal liver. Ductal plate malformation .
