PMC6949666_01
Gray-scale ultrasonography at the 13 weeks of gestation. Severe oligohydramnios was noted.
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Because of severe oligohydramnios (Figure 1), ultrasonographic images were not very clear, and no clear 3D images were obtained.
Gray-scale ultrasonography at the 14 weeks of gestation. Two femurs, two tibiae, and two fibulae were visualized.
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However, the lower extremities remained in the fixed extension, but all long bones were visible (Figure 2).
Color Doppler ultrasonography at the 13 weeks of gestation. A single umbilical artery was seen.
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Color Doppler ultrasound revealed a single umbilical artery (Figure 3).
Macroscopic image of the delivered baby. A fused single lower extremity was noted.
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On the postnatal examination, the baby weighed 60 grams and the external examination revealed the fusion of both lower extremities (Figure 4).
Postmortem CT images of the delivered baby. Two femurs, two tibiae, and two fibulae were contained in the single lower limb, and none of them was fused (a). Agenesis of lower lumbar and sacral spines was noted (b).
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Postmortem imaging studies with the radiography and CT scans revealed a single lower limb containing two femurs, two tibiae, and two fibulae, and none of them were fused (Figure 5(a)). Agenesis of the lower lumbar and sacral spines was also noted (Figure 5(b)).
Results of the 75 g oral glucose tolerance test. (a) Two days postpartum: HOMA - R = 0.47, QUICKI = 0.44, MI = 9.38, DI = 4.81, and II = 0.51. (b) Seventeen weeks postpartum: HOMA - R = 0.82, QUICKI = 0.40, MI = 8.02, DI = 6.08, and II = 0.76. HOMA-R: homeostasis model assessment insulin resistance; QUICKI: quantitative insulin-sensitivity check index; MI: Matsuda index; DI: disposition index; II: insulinogenic index.
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A 75 g oral glucose tolerance test (OGTT) was performed 2 days postpartum, which showed a mildly impaired glucose tolerance pattern of the mother (Figure 6(a)). At 17 weeks postpartum, another OGTT was carried out and the blood glucose levels were in the normal range (Figure 6(b)).