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Gynaecology & Obstetrics General 4b2bf473

All of the following are true about anencephaly except :

A
Facial presentation
B
Increased alpha-fetoprotein
C
Enlarged adrenal gland
D
Polyhydramnios
High-Yield Explanation
Ans. is c i.e. Enlarged Adrenal gland Anencephaly : It is characterised by absence of the cranial vault and cerebral hemispheres.deg It is the most common type of neural tube defect.deg Caused by failure of closure of Rostral Neuropore at an early embryonic stage. Pathological features : Forebrain and midbrain are absent. Cerebellum and Hindbrain are less involved or completely spared. Base of skull and facial bones are not affected. Pituitary gland is either absent or hypoplastic.deg As a result : Aarenai gnu is gland is diminished in slze.deg Such fetuses have bulging eyes, sho neck and a large tongue. Complications causea by Anencephaly during Pregnancy Polyhydramnios : seen in 35% cases.deg Causes : -- Diminished fetal swallowingdeg Secretion of CSF directly into the amniotic cavitydeg -- Excessive micturition.deg Preterm labour : due to associated polyhydramnios. Ma/presentation : Face presentation (Most common)deg and Breech presentation. Rather most common fetal anomaly responsib' for face presentation is Anencephaly Tendency for post maturity.deg Cause : -- Insufficient production of coisol from fetal adrenals leading to diminished oestriol. Complications during Labour Shoulder dystociadeg : Most common complication of anencephaly during labour. Obstructed labourdeg Risk of recurrence is 5% after one affected child and 13% after two affected children.deg Diagnosis : By ultrasound : Demonstration of - a. Absence of cranial vault and b. Angiomatous brain tissue. Time >14 weeks and Accuracy - 100% It can be diagnosed earliest by 8-10 weeks on ultrasound.deg Elevated levels of maternal serum alpha feto proteins.deg By amniocentesis : Purpose of amniocentesis is to measure concentration of alpha - feto protein (AFP) and acetyicholinesterase in amniotic fluid. Amniotic fluid acetyl cholinesterase has better diagnostic value than amniotic fluid AFP.deg

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