Case presentation:
A 17-year-old G6P0A5 woman, with a history of Tramadol, Methamphetamine, Pregabalin and Chloral hydrate use before and during pregnancy, admitted to the emergency department at 36 weeks and 5 days of gestation with severe vaginal bleeding and uterine contraction. The woman was suffering from poor living conditions. She was transferred by police to reform institute on charges of drugs and abnormal behavior several times, the last of which was during her late pregnancy. Therefore, she did not receive any health care, and the health status of the fetus was not determined, whether through an ultrasound or other tests.
Methods: The woman’s psychological condition was not determined because she was not presented to a psychiatrist. Upon clinical examination, heart rate was 84, and blood pressure was 110/70. Laboratory tests were unremarkable except for decreased hemoglobin due to blood loss. An ultrasound was performed, which revealed an anencephalic single fetus with gastroschisis, ectopia cordis, femur length (FL) was estimated with 28 gestational weeks). The results of the ultrasound and the physical examination indicated the presence of placental abruption. The fetal heart rate tracing demonstrated a deceleration down to a nadir of 50 beats per minute.
An emergent cesarean delivery was performed.
Conclusion and Results : A male neonate was born in a severely poor general condition, weighing 600 grams, and passed away seven minutes later. Multiple fetal anomalies involving all body systems were observed including anencephaly, exophthalmos of both eyes, cleft palate, absence of the nose (Fig.1). Gastroschisis (Fig.2), Ectopia cordis (Fig.3). Absence of the testes and a small penis, absence of the spinal cord, imperforate anus, and clubfoot (Fig.4). These anomalies were detected upon further examination of the newborn’s body systems,
There exists no familial history indicative of embryos displaying congenital deformities.