Early ultrasonographic changes in Fowler syndrome features and review of the literature.
BACKGROUND
Fowler syndrome is characterized by hydranencephaly, brain stem and basal ganglion calcifications, a glomeruloid vasculopathy of the brain vessels, and a fetal akinesia deformation sequence with muscular hypoplasia. The natural progression of the ultrasonographic features of Fowler syndrome has never been described.


METHODS
Case report and review of the literature.


RESULTS
A primiparous woman with a negative ultrasound at 11 weeks of pregnancy was noted at 15 weeks to have fetal nuchal thickening, generalized skin edema, prominent lateral ventricles, akinesia with arthrogryposis, and pterygia. At 18 weeks, a cystic hygroma with facial edema, hypertelorism, and hydrocephaly were noted; the limb deformity was still evident. Within 1 week, the cystic hygroma regressed partially, but the hydrocephaly deteriorated.


CONCLUSIONS
The multiple ultrasonographic features of Fowler syndrome may not occur simultaneously and their severity may vary with gestational age.
Usta
Ihab M
IM
Department of Obstetrics and Gynecology, American University of Beirut Medical Center, Beirut, Lebanon.
AbuMusa
Antoine A
AA
Khoury
Nabil G
NG
Nassar
Anwar H
AH
D000015:Abnormalities, Multiple / Q000000981:diagnostic imaging*; D000025:Abortion, Eugenic; D001176:Arthrogryposis / Q000000981:diagnostic imaging; D005260:Female; D005315:Fetal Diseases / Q000000981:diagnostic imaging*; D006801:Humans; D006832:Hydranencephaly / Q000000981:diagnostic imaging*; D017880:Limb Deformities, Congenital / Q000000981:diagnostic imaging*; D048208:Nuchal Translucency Measurement; D011247:Pregnancy; D011256:Pregnancy Outcome; D013577:Syndrome; D016216:Ultrasonography, Prenatal