NEONATE WITH OCCIPITAL SCALP DEFECT

摘要

A female neonate was delivered at 38 weeks' gestation to an i 8-year-old, gravida 1, Native American female whose antepartum course was notable for crystal methamphetamine and tobacco use early in pregnancy. Prenatal care has been initiated at 11 weeks of gestation, and an ultrasound performed at approximately 20 weeks revealed findings interpreted as a large posterior fossa cyst with mass effect. The cerebellum has not been well visualized, although the impression was that some cerebellar tissues were present. These features were overall felt to reflect a Dandy-Walker cyst. Additional ultrasonographic impressions included a probable porencephalic cyst on the right side, ventriculomegaly, possible agenesis of the corpus callosum arid overall significant absence of brain parenchyma in the right hemisphere. Serial follow-up ultrasound evaluations were performed at approximate 4-week intervals, demonstrating essentially the same intracranial ultrasonographic findings. Of note was that other organs showed appropriate growth progression.At delivery by cesarean section, the posterior aspect of the neonate's scalp was noted to be covered by a thin, tense membrane, which ruptured during the procedure. Apgar scores were 7 and 9 at 1 minute and 5 minutes, respectively, and death occurred within hours of birth.