PMC5894013_01
Doppler ultrasound images: (A) Axial section of the foetus showing single umbilical artery. (B) Axial section of the abdomen at the level of fundic bubble showing absence of the spine. (C) Sagittal section of the foetus showing absence of the lumbar and sacral spine. (D, E) Axial sections of the foetus showing normal left ventricle measuring 7.6 mm and normal cisterna magna measuring 5.5 mm.
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On axial sections, abrupt termination of the spine was noted just above the level of fundic bubble (Figure 1B). On sagittal sections, the lumbosacral spine was not visualized (Figure 1C). No evidence of ventriculomegaly was noted (Figure 1D, 1E). On a Doppler examination, a single umbilical artery was found (Figure 1A).
Foetal T2WI MRI (non-contrast images): (A, B) Sagittal sections of the foetus showing abrupt termination of the spinal cord and absence of the lumbosacral spine. (C, D) Axial sections of the foetal abdomen showing abrupt termination of the spine at the level of the stomach bubble. (E) Section of the foetal limbs showing clubbed feet.
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On MRI, these findings were confirmed (Figure 2A, 2B), and some additional findings were noted, such as flexion contractures of the hip and knee joints, giving "frog-like" appearance, and the presence of club feet (Figure 2E). The spinal cord was visualized and was seen terminating above the level of the fundic bubble (Figure 2C, 2D).
Clinical picture of the delivered foetus confirming the imaging findings
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A foetus weighing 650 grams was delivered without any complications (Figure 3).