Presence of Cervical Vertebral Anomalies with Concomitant Non-Communicating Hydrocephalus and Multicystic Kidney in a Female Fetus: Where VACTERL-H Meets MURCS

Fetal Pediatr Pathol. 2022 Oct;41(5):871-880. doi: 10.1080/15513815.2021.1994068. Epub 2021 Oct 23.

Abstract

Background: Congenital multisystemic lesions with co-occurrence of non-random malformations, such as VACTERL-H or MURCS association, often pose serious threads to the newborn and still constitute an antenatal diagnostic dilemma.

Case report: A malformed fetus with VACTERL-H association at 20 gestational weeks had a skin-covered neural tube defect (NTD) of the lower cervical spine, concomitant hydrocephalus, as well as unilateral multicystic dysplastic kidney and the suspicion of mullerian duct anomaly as potentially assigned to MURCS association.

Discussion/conclusion: We were able to demonstrate how well-defined, standardized volumetric reconstruction of diagnostic views displaying fetal pathology in utero might aid early and precise diagnosis of multi-organ malformations. Application of modern diagnostic imaging tools is helpful in delineation of the most likely diagnoses (VACTERL-H vs. MURCS) as further specified during detailed pathologic work-up and might consequently facilitate individually tailored interdisciplinary counseling, as in the case presented here.

Keywords: 3D ultrasound; MURCS; VACTERL-H; malformation; prenatal.

Publication types

  • Case Reports

MeSH terms

  • 46, XX Disorders of Sex Development
  • Abnormalities, Multiple* / diagnosis
  • Abnormalities, Multiple* / pathology
  • Anal Canal / abnormalities
  • Cardiovascular Abnormalities
  • Congenital Abnormalities
  • Digestive System Abnormalities
  • Esophagus / abnormalities
  • Female
  • Fetus / pathology
  • Genetic Diseases, X-Linked
  • Heart Defects, Congenital* / pathology
  • Humans
  • Hydrocephalus* / diagnosis
  • Hydrocephalus* / pathology
  • Kidney / abnormalities
  • Kidney / pathology
  • Limb Deformities, Congenital* / diagnosis
  • Mullerian Ducts / abnormalities
  • Mullerian Ducts / pathology
  • Multicystic Dysplastic Kidney* / complications
  • Multicystic Dysplastic Kidney* / diagnosis
  • Multicystic Dysplastic Kidney* / pathology
  • Musculoskeletal Abnormalities
  • Pregnancy
  • Spine / abnormalities
  • Spine / pathology
  • Trachea / abnormalities

Supplementary concepts

  • Mullerian aplasia
  • VACTERL Association With Hydrocephalus
  • VACTERL association