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Case Reports in Obstetrics and Gynecology
Volume 2014, Article ID 495702, 4 pages
http://dx.doi.org/10.1155/2014/495702
Case Report

Prenatal Diagnosis of a Fetus with Ring Chromosomal 15 by Two- and Three-Dimensional Ultrasonography

1Department of Obstetrics and Gynecology, Medical College Science of Santa Casa of São Paulo (FCMSCSP), 01221-020 São Paulo, SP, Brazil
2Department of Obstetrics, Federal University of São Paulo (UNIFESP), Rua Carlos Weber 956, Apartamento 113 Visage, 05303-000 São Paulo, SP, Brazil
3Department of Gynecology and Obstetrics, Baylor College of Medicine and Texas Children’s Hospital, Houston, TX, USA
4Department of Genetics, Federal University of São Paulo (UNIFESP), 77030 São Paulo, SP, Brazil

Received 29 June 2014; Revised 4 October 2014; Accepted 5 October 2014; Published 20 October 2014

Academic Editor: Eliezer Shalev

Copyright © 2014 Ingrid Schwach Werneck Britto et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

We report on a prenatal diagnosis of ring chromosome 15 in a fetus with left congenital diaphragmatic hernia (CDH) and severe intrauterine growth restriction (IUGR). A 31-year-old woman, gravida 2 para 1, was referred because of increased nuchal translucency at gestational age of 13 weeks. Comprehensive fetal ultrasound examination was performed at 19 weeks revealing an early onset IUGR, left CDH with liver herniation, and hypoplastic nasal bone. Three-dimensional ultrasound (rendering mode) showed low set ears and depressed nasal bridge. Amniocentesis was performed with a result of a 46,XX,r(15) fetus after a cytogenetic study. A 1,430 g infant (less than third percentile) was born at 36 weeks. The infant presented with respiratory failure and died at 2 h of life. Postnatal karyotype from the umbilical cord confirmed the diagnosis of 15-ring chromosome. We described the main prenatal 2D- and 3D-ultrasound findings associated with ring chromosome 15. The interest in reporting the present case is that CDH can be associated with the diagnosis of 15-ring chromosome because the critical location of the normal diaphragm development is at chromosome 15q26.1-q26.2.