Andreea I Gorcea and Nicolae Suciu
Institute for Mother and Child Health Alessandrescu-Rusescu, Romania
Carol Davila University of Medicine and Pharmacy, Romania
Scientific Tracks Abstracts: J Women's Health Care
Statement of Problem: The vein of Galen aneurysm represents a complex malformation including multiple arteriovenous fistulae located at the midline of the brain, close to midbrain. Even rare, VGA is the most common diagnosed vascular prenatal malformation of the brain. In fact, VGA is a persistency and dilatation of the precursor of vein of Galen, the median prosencephalic vein of Markowski. Methodology: 32 year pregnant woman, G2P1, 23 weeks, was referred to our FMU for an amniocentesis due to an increased nuchal fold at the anomaly scan. The second opinion scan detected a large cystic structure above the thalamus in the midline of the brain, close to the third ventricle, with turbulent color Doppler flow, high velocity/low resistance. Results: Additional finding was the presence of cardiomegaly as a direct sign of cardiac failure. Taking into account the early gestational age, the magnitude of the shunt and the associated factors (cardiomegaly, enlarged neck veins) the couple was counseled about the poor prognosis due to imminent cardiac insufficiency (early signs), leading to a high rate of intrapartum and postpartum morbidity and mortality or the potential mental and physical impairment. Conclusion: VGA is a rare condition with high morbidity and mortality rates when associated with other complications/ abnormalities. The prognosis is directly linked to these complications. The particularity of the case is the earliest diagnosis of this condition until now (23 weeks), usually diagnosed in the third trimester and the magnitude of the shunt with early signs of cardiac failure.
Andreea I Gorcea is a Senior Consultant in Obstetrics’ Gynecology and Fetal Medicine Specialist at the Centre for Excellence in Maternal Fetal Medicine, Institute for Mother and Child Health Alessandrescu-Rusescu in Bucharest, Romania. She has completed her PhD in Obstetrics’ Gynecology. Her interest is in maternal-fetal medicine and fetal surgery. She completed her Fellowship and FMF Diploma in Fetal Medicine at Fetal Medicine Research Institute, Fetal Medicine Foundation, London, UK. She has the FMF Certification in first trimester and second trimester screening for chromosomal abnormalities, cardiac fetal scans, invasive procedures, anomaly scans, growth scans, screening for preeclampsia and premature birth. She has worked on her research studies in different hospitals across UK; King’s College Hospital London, University College Hospital London, North Middlesex Hospital London, Homerton University Hospital London, Medway Maritime Hospital, Southend University Hospital and Princess Royal University Hospital Orpington.
E-mail: [email protected]