Embryonic delay in growth and development related to confined placental trisomy 16 mosaicism, diagnosed by I-Space Virtual Reality.
OBJECTIVE
To demonstrate the use of a novel three-dimensional (3D) virtual reality (VR) system in the visualization of first trimester growth and development in a case of confined placental trisomy 16 mosaicism (CPM+16).


METHODS
Case report.


METHODS
Prospective study on first trimester growth using a 3D VR system.


METHODS
A 34-year-old gravida 1, para 0 was seen weekly in the first trimester for 3D ultrasound examinations.


METHODS
Chorionic villus sampling was performed because of an enlarged nuchal translucency (NT) measurement and low pregnancy-associated plasma protein-A levels, followed by amniocentesis.


RESULTS
Amniocentesis revealed a CPM+16. On two-dimensional (2D) and 3D ultrasound no structural anomalies were found with normal fetal Dopplers. Growth remained below the 2.3 percentile. At 37 weeks, a female child of 2010 g (<2.5 percentile) was born. After birth, growth climbed to the 50th percentile in the first 2 months.


CONCLUSIONS
The I-Space VR system provided information about phenotypes not obtainable by standard 2D ultrasound. In this case, the delay in growth and development could be observed very early in pregnancy. Since first trimester screening programs are still improving and becoming even more important, systems such as the I-Space open a new era for in vivo studies on the physiologic and pathologic processes involved in embryogenesis.
Verwoerd-Dikkeboom
Christine M
CM
Department of Obstetrics and Gynaecology, Division of Obstetrics and Prenatal Medicine, Erasmus MC University Medical Centre Rotterdam, Rotterdam, The Netherlands. c.verwoerd@erasmusmc.nl
van Heesch
Peter N A C M
PN
Koning
Anton H J
AH
Galjaard
Robert-Jan H
RJ
Exalto
Niek
N
Steegers
Eric A P
EA
D000328:Adult; D000649:Amniocentesis; D015193:Chorionic Villi Sampling; D002885:Chromosomes, Human, Pair 16; D005260:Female; D005317:Fetal Growth Retardation / Q000000981:diagnostic imaging* / Q000235:genetics / Q000378:metabolism; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D021621:Imaging, Three-Dimensional; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D050498:Live Birth; D009030:Mosaicism; D011247:Pregnancy; D011263:Pregnancy Trimester, Third; D011266:Pregnancy-Associated Plasma Protein-A / Q000032:analysis; D014314:Trisomy; D016216:Ultrasonography, Prenatal; D014584:User-Computer Interface
D011266:Pregnancy-Associated Plasma Protein-A