title: Biochemical and Doppler predictors of poor perinatal outcome in a fetus with four umbilical vessels.
abstract: Unexpected elevation of maternal serum alpha-fetoprotein (MSAFP) in women with anti-phospholipid syndrome has already been described as a predictor of fetal death. In this report we present a case of a pregnant woman with elevated second trimester MSAFP, in which Doppler ultrasound at 28 weeks suggested very poor fetal prognosis. A cesarean section was performed, but 2 days later the infant died due to distress. The only remarkable feature at post-mortem study was the finding of four vessels in the umbilical cord. Conventional investigation of the mother led us to the diagnosis of a primary anti-phospholipid syndrome. The finding of such an association should alert clinicians to the increased risk of fetal death. Precocious Doppler ultrasound examination may be the elective non-invasive technique to monitor such high risk fetuses.
mesh_terms: D000328:Adult; D000653:Amniotic Fluid / Q000737:chemistry; D016736:Antiphospholipid Syndrome / Q000175:diagnosis*; D005260:Female; D005313:Fetal Death; D005865:Gestational Age; D006801:Humans; D008423:Maternal Age; D049590:Postpartum Period; D011247:Pregnancy; D011248:Pregnancy Complications; D018566:Pregnancy, High-Risk; D016216:Ultrasonography, Prenatal; D014470:Umbilical Cord / Q000002:abnormalities*; D000509:alpha-Fetoproteins / Q000032:analysis*
chemical_list: D000509:alpha-Fetoproteins