* Sonographer, Moufia"s street, 97400 Saint-Denis, Ile de la Réunion, France;
** Department of Gynecology, Félix Guyon Hospital, 97400Saint-Denis, Ile de la Réunion, France;
*** Department of Neonatology, Hôpital Félix Guyon, 97400Saint-Denis, Ile de la Réunion, France.

Case report

This is 24th week scan of a woman with unremarkable history. She didn"t undergo triple test and first trimester ultrasonography during her pregnancy. Our investigation revealed:

• Clinodactyly of the right hand with small thumb in abnormal position;

• Severe ectrodactyly of the left hand (deep split hand with two rudimentary fingers);

• Transposition of the great arteries and atrioventricular discordance wit atrioventricular defect;

• Moderate polyhydramnios;

The amniocentesis revealed normal karyotype (46, XY) and a normal amniotic fluid alpha-fetoprotein level. The baby was delivered at 33 weeks (1900g) and the esophageal and anal atresias were discovered postnatally requiring surgical treatment. The heart and limbs anomalies were confirmed.

Images 1 and 2: 3D ultrasonography at 24th week of gestation showing the right hand of the baby with abnormal position of the thumb.

Images 3 and 4:  3D ultrasonography at 24th week of gestation showing the left forearm of the baby and split hand with two small fingers.

Images 5 and 6: 2D sonography; 24the week; four chamber view with atrioventricular septal defect.

Images 7 and 8: Postnatal appearance of the baby.

Image 9: Postnatal appearance of the baby - left hand.