Speaker
Description
DEPARTMENT OF OBSTETRICS AND GYNAECOLOGY, AIIMS RAIPUR
ABSTRACT
Neural tube defect (NTD) is a result of dysfunction in neurulation process between third and fourth week of gestation.Hydrocephalus is a disorder of cerebrospinal fluid physiology resulting in abnormal expansion of the cerebral ventricles and increased intraventricular pressure . Congenital hydrocephalus, most commonly involving aqueduct stenosis, has been linked to genes that regulate brain growth and development. The incidence of a congenital hydrocephalus is 2-3 of 5000 pregnancies.
Here is a case of 25 year old third gravida with history of previous 2 vaginal deliveries, an intra uterine death at 7 month in 2017 and another pregnancy with neonatal death on day 3 due to meconium aspiration syndrome in 2018 , attended antenatal OPD of AIIMS Raipur at 34 week of pregnancy with her usg at 28 weeks suggestive of gross hydrocephalus with suspected fetal spina bifida at lumbosacral region and polyhydramnious . She delivered a preterm,alive, girl of 2.26kg with gross hydrocephalus and Myeloschysis on 25/1/20 by emergency caesarean section done at 35 weeks in view of 2nd stage arrest of labour .
Fetus with NTD and Congenital hydrocephalus requires early diagnosis of the anomaly, and plan further management involving multidisciplinary approach comprising of obstetricians, radiologist, neonatologist and paediatric surgeons . The risks and benefits of mode of delivery prior to labor should be discussed.
