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Mild holoprosencephaly secondary to teratogenic effect of maternal diabetes


Autopsy Report
No: 3082
Dr. Seyed Reza Samsamshariat
Pathologist
Medical Board Registration
No: 32482

www.drsamsampathology.ir
....................

Patient:######q
Father: ########t
Age/Sex: 35 weeks/Male
Gynecologist:#######l


Date of death: IUFD
Cause of death: Unknown
Date of Autopsy: 29Jan2011
Autopsy No: 3082

Clinical information:o

The cadaver belongs to a 35 weeks old female fetus who had a 30 years old mother a 41 years old father That were not consanguineous. The mother"s parents are diabetic and her uncles and ants are deaf. This was the 2nd pregnancy of this mother in which there was not any presentation of hypertension or spotting but she had diabetes and received insulin 16 units per day. Because of Rh incompatibility she found a positive indirect coombs with a titer of 1/16 to 1/32 . There was a UTI too which had been treated. IUFD had occurred 10 days ago. Sonography reports had shown a mild hemolytic anemia. The first Child of this mother is 10 yr old and is healthy.l

Gross Examination of the Body:l

The body is a male with a crown-heel height of 46.5 cm and a crown-rump height of 31cm. The lower limb was 17 cm and head circumference 34 cm. There is not any bruise but generalized maceration can be seen. A mild cyanosis is seen and there is (+) edema. There is telecanthus and blepharophimosis (Figure 1). Microstomia is seen. The nasal bridge is wide and face is flat (Figure 2). Auricular lobule seems to be large. The palmar lines do not match with down syndrome (Figure 3). The posterior part of the trunk is normal. The genital is male type and testicles are in scrotum. The umbilical cord is 8 cm in long and 1.8 cm in diameter. There are 3 vessels in its cut surface. s


The Examination of Dissected Body:o

The thoracic wall is normal. There"s not emphysema in it. The diaphragm is felt in the right and left. There is bilateral bloody hydrothorax (Figure 4). Thymus is not atrophic and does not have any hemorrhage or emphysema. It is 3*2*1.5 cm and there is petechia on its surface. Pericardium is normal. The heart is cone shaped and is 4*3.5*2 cm. The oval foramen is open. The esophagus is normal and there is not any fistula or atresia in it. There is no mecunium plucking in the bronchus. Each lung is 6*4*2 cm. They are airless and hyperemic. The abdominal cavity has a mild ascites. The intestinal rotation is normal and colon is distended and it"s diameter is 1.5 cm. Stomach is 2.5*1.5*0.5 cm. The liver is soft and autolytic. It is 10*7*4 cm. Spleen is 4.5*2.5*2 cm with a normal shape. Ureters have normal path and each is 0.2cm in diameter. Each of the kidneys is 4*2.5*2.5 cm and has a normal shape. There is not any infarction or abscess in the kidneys. The cortex is 0.1 cm and pale. Each of the adrenal glands is 3*2*1.5 cm. the medulla is hemorrhagic. The urethra has not any obstruction.o

Bladder is 4*2*1 cm and has a thickness of 0.2 cm in its wall.o


The external genitalia has no pathologic feature . The testicles are felt in the scrotum. In the brain examination the hemispheres are not separated completely and septum pellucidum is not seen between ventricles.a

Miroscopic Examination:
In the microscopic examination of the samples obtained from different organs all of the tissues show autolysis.o


Dx; Asphyxia (Secondary to erythroblastosis fetalis) +Mild Holoprosencephaly (Secondary to teratogenic effects of mether"s diabetes)i

Pathologist:
Dr. Seyed Reza Samsam Shariat

Address: Dr.Samsam Shariat Laboratory , Abazar St. Khorasgan, Esfahan,
IRAN.

Telephone: +983115228677
E-mail:info@drsamsampathology.ir


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