Chiari malformation, type II

Ishraq Dhaifalah, MD, PhD

Department of Medical Genetic and fetal Medicine. University Hospital, Olomouc, Czech Rep.

A 24 year old mother G2, P1 with a healthy first child was referred for first trimester screening. The mother gave a history of intake of 2 medications - Doxybene [which is a tetracycline antibiotic] and Ibalgin at 13 weeks gestation. Doxybene and Ibalgin are drugs known to affect pregnancy, but not during the first trimester. She presented again at 20 weeks gestation and the following ultrasound images were obtained. The fetus showed:

Lemon sign of the head and ventriclomegaly:

ima1

Myelomeningocle at the lumbosacral region:

ima2
ima3

A diagnosis of Chiari malformation type II was established and the pregnancy was terminated.

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