<- Home <- Arhive <- Vol. 25, Issue 4, December 2017



Rom J Leg Med25(4)359-363(2017)
DOI:10.4323/rjlm.2017.359
© Romanian Society of Legal Medicine


Forensic approach in term pregnancy with plurimalformat fetus

L. G. Daina, S. M. Armean, E. Rosca, O. Tica, G. Mihalache, C. M. Daina


Abstract: Prophylactic checks performed during pregnancy of a 36 years old mother Gesta I/Partum I (GI/PI), led to the diagnosis in the late first trimester of a serious fetal plurimalformative syndrome. Recommendation of therapeutic abortion was received with reluctance by the family and the mother refused this alternative. The family benefits from counseling throughout the pregnancy. Died a few minutes after birth, the malformed infant, was diagnosed at the autopsy with multiple lesions incompatible with life: lumbar myelomeningocele (rahischisis), secondary hydrocephalus, laparoschisis, vicious positioning of the legs in relation with the pelvic bones (campomelic dysplasia), pulmonary hypoplasia, foramen ovalae and ductus arteriosus permeable, short colon (25 cm) without anatomical differences between segments, anorectal agenesis, malformations of hepatosplenic shape, abortive gallbladder, lack of urethra and external orifice outlet of the urinary bladder and the presence of testes in the pelvic region (confirmed by histopathological examination). Framing in a malformative syndrome was difficult, complex malformation lesions could be included in campomelic dysplasia or in another unidentified malformative syndrome from the literature. The ethical implications of this case underscores the importance of genetic counseling and genetic testing. In case of a potential claim, implementation in clinical practice of a forensic document like the Agreement on keeping the pregnancy may represent a sample that exempt the physician in an eventual responsibility.
Keywords: newborn, plurimalformative syndrome, campomelic dysplasia, ethics, genetic testing, forensic document.



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