November, 15 1998
I would like some thoughts on the following baby:
Delivered at 36 weeks for footling breech. Pregnancy complicated
by severe polyhydramnios; family history on-contributory, parents non-consanguineous
(Portuguese and English). The facial and general appearance (severe club
feet, overlapping fingers, flexed wrists, abnormal palmar creases, cleft
palate, severe micrognathia and glossoptosis, flat face and flat nasal
bridge, and squarish appearance of the head) suggests campomelic dysplasia.
However, on skeletal survey there is no long bone bowing, scapulae are
normal size and the is advancement of the bone age (the distal femoral
epiphysis is ossified). 12 pairs of ribs. I.e., there are none
of the radiologic criteria of CD. There is a severe segmentation
defect in the cervical region with kyphoscoliosis at that level.
Abdominal U/S and 2dECHO still pending. Currently intubated for
upper a/w obstruction. On physical examination this babe looks just
like the examples of CD in Gorlin, Cohen and Levine.
What am I dealing with?Thank you all for your help.
Marg