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CONGENITAL DIAPHRAGMATIC EVENTRATION IN A NEWBORN: POSTMORTEM MRI AND PATHOLOGICAL CHARACTERISTICS

Tumanova U.N.¹, Lyapin V.M.¹, Burov A.A.1 , Bychenko V.G.¹,

Shchegolev A.I.¹, Serova N.S. ²

The literature data were analyzed and the own observation of a newborn girl with congenital diaphragmatic eventration complicated by the development of nonimmune fetal hydrops and lung hypoplasia, is presented.

In the presented observation, during prenatal screening of the second trimester with ultrasound revealed signs of coarctation of the isthmus of the aorta and nonimmune dropsy in the fetus. On the 2nd day after the hospitalization of the pregnant woman to the Center, at the time of 30-31 weeks, premature spontaneous delivery of a live premature baby girl weighing 2891 g, body length 44 cm occurred. Immediately after birth, the child was transported to the intensive care unit in extremely serious condition. An X-ray examination was performed at the newborn lifetime of 35 minutes. According to the results of X-ray examination, it was impossible to exclude a congenital right-sided diaphragmatic hernia with the entry of the liver into the right pleural cavity. At the lifetime of 2 hours 16 minutes and 3 hours 16 minutes, at X-ray examination determined the right-sided strained pneumothorax, hydrothorax on the left, hydroperitoneum, pneumoperitoneum, generalized edema of soft tissues. Despite intensive therapy and resuscitation, the condition of the newborn deteriorated and death occurred at the age of 14 hours and 30 minutes. According to postmortem MRI and autopsy, congenital right-sided diaphragmatic eventration, nonimmune fetal dropsy and lung hypoplasia were revealed, which were the direct cause of death. The essential point of the postmortem study is the performance of postmortem MRI, which allowed to establish the exact location, size and content of the diaphragmatic eventration, to diagnose nonimmune fetal hydrops with a quantitative assessment of the volume of free fluid in the serous cavities and the severity of anasarca, as well as to diangostate the degree of hypoplasia of the lungs. Verification of diaphragmatic eventration was carried out during histological and immunohistochemical studies.

1 - V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology.

2 - I.M. Sechenov First Moscow State Medical University (Sechenov University). Russia, Moscow.

 

Keywords: congenital diaphragmatic eventration, congenital diaphragmatic hernia, nonimmune fetal hydrops, lung hypoplasia, newborn, autopsy, postmortem MRI.

 

 

Corresponding author:  Tumanova U.N., e-mail: Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript

 

For citation: Tumanova U.N., Lyapin V.M., Burov A.A., Bychenko V.G., Shchegolev A.I., Serova N.S. Congenital diaphragmatic eventration in a newborn: postmortem mri and pathological characteristics REJR 2021; 11(4):94-104. DOI: 10.21569/2222-7415-2021-11-4-94-104.

Received:        21.09.21 Accepted:       02.12.21