Caudal Regression Syndrome
DOI :
https://doi.org/10.18041/2390-0512/biociencias.1.11512Mots-clés :
Caudal Regression Syndrome, Caudal Agenesis, Sacral regressionRésumé
Background: Caudal Regression Syndrome is an infrequent congenital malformation of the vertebral spine’s lower segments characterized by a truncated medullar cone and aplasia or hypoplasia of the sacrum. Specifically, sacral agenesis represents an incidence of 0.01 to 0.05 of every newborn. Among the main risk factors are elevated glycosylated hemoglobin, hormonal imbalance, and lipid protein metabolic disorder. A correlation has been established between anomalous pregnancies and congenital malformations in newborns, with a prevalence of 5 to 10% in children of diabetic mothers, with an incidence of 1 per 350 cases, representing a 200% rise over the general population. Objective: To report an extremely uncommon epidemiologically rare case of Caudal Regression Syndrome, characterized by caudal musculoskeletal involvement. Clinical case: a 27-year-old female in her 34th week of gestation during her second pregnancy presented to the high specialty, high-risk pregnancy consultation with a background of glycemia of 205mg/dl, glycosylated hemoglobin percentage (%HbA1c) of 10.1%, and estimated average glucose levels of 243mg/dl. The patient arrived at the emergency room during active labor with premature membrane rupture, both deciding factors for pregnancy termination. The outcome was a sole female live product with a vertebral spine interrupted approximately by T10, non-palpable iliac crests, sacrum, and coccyx, and shortening of hypotrophied inferior extremities. Conclusion: successful prevention in the early diagnosis of malformations during pregnancy requires strict prenatal control for any pregnant woman with metabolic risk factors. The first prenatal consultation presents an opportunity to perform diabetic screening. If diagnosed, follow-up procedures such as ultrasounds at a second level of medical care should be performed for the timely detection of congenital malformations associated with high levels of glycemia.
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Références
Renshaw TS. Sacral agenesis. A classification and review of twenty-three cases. J Bone Joint Surg. 60(3):373–83. (Internet) 1978 (Cited on March 4, 2024). Available at: https://pubmed.ncbi.nlm.nih.gov/649642/
Kylat RI, Bader M. Caudal Regression Syndrome. Children (Basel). 7(11):211. (Internet) 2020 (Cited on March 4, 2024). Available at: http://dx.doi.org/10.3390/children7110211
Luque MJ, Fernández R, Tuca MJ, Luco M, de Barbieri MF, Tapia JL. Caudal Regression Syndrome: A Clinical Case. Rev. chil. pediatr. (Internet). April 2010 (cited on March 4, 2024); 81(2):148-154. Available at: http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0370-41062010000200007&lng=es http://dx.doi.org/10.4067/S0370-41062010000200007
Mendez-Salazar M, Ortega-Coto C, Soto-Zuñiga M, Tames-Robles A. Sacral Agenesis. Rev Clin HSDJ. (Internet) 2020 (Cited on March 4, 2024). 10(2):1–8. Available at: http://www.medigraphic.com/pdfs/revcliescmed/ucr-2020/ucr202a.pdf
Zepeda TJ, García MM, Morales SJ, Pantoja HMA, Espinoza GA. Caudal Regression Sequence: A Clinical-Radiological Case. Rev Chil Pediatr. (Internet) 2015 (Cited on March 4, 2024). 86(6):430–5. Available at: http://dx.doi.org/10.1016/j.rchipe.2015.07.021
Bilbao LS. Caudal Regression Syndrome: Bibliographic Review (Internet). (Zaragoza, Spain.): University of Zaragoza; 2020. Available at: https://zaguan.unizar.es/record/111428/files/TAZ-TFG-2020-766.pdf
Wender-Ożegowska E, Wróblewska K, Zawiejska A, Pietryga M, Szczapa J, Biczysko R. Threshold values of maternal blood glucose in early diabetic pregnancy – prediction of fetal malformations. Acta Obstet Gynecol Scand (Internet). 2005 (cited on March 4, 2024);84(1):17–25. Available at: https://pubmed.ncbi.nlm.nih.gov/15603562/
Soto-López Susana, Loranca-Islas César Alfredo, González-Montenegro Karen Isabel, Rivera-Aráuz Alejandro. Caudal Regression Syndrome in Maternal Diabetes: Case Report. Ginecol. obstet. Méx. (Internet). 2023 (cited on March 4, 2024); 91(5): 371-376. Available at: http://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S030090412023000500371&lng=es. Epub 01-Sep-2023. https://doi.org/10.24245/gom.v91i5.8062
Karthiga V, Kasinathan A, Kumar L, Palanisamy S. Caudal Regression Syndrome Group 2. Indian J Pediatr (Internet) 2021 (Cited on March 4, 2024); 88(4):418–9. Available at: http://dx.doi.org/10.1007/s12098-020-03354-4
Purbasari U, Nazar H, Miraj F, Aprilia D, Widiani W, Suprihatin M, et al. Caudal Regression Syndrome from Radiology and Clinical Perspective: A Case Series and a Proposed New Integrated Diagnostic Algorithm. Radiol Case Rep (Internet) 2023 (Cited on March 4, 2024); 18(7):2478–86. Available at: http://dx.doi.org/10.1016/j.radcr.2023.04.015
Ranganath P, Perala S, Nair L, Pamu PK, Shankar A, Murugan S, et al. A Newly Recognized Multiple Malformation Syndrome with Caudal Regression Associated with a Biallelic c.402G>A Variant in TBX4. Eur J Hum Genet (Internet) 2020 (Cited on March 4, 2024);28(5):669–73. Available at: http://dx.doi.org/10.1038/s41431-020-0572-5
Palumbo P, Accadia M, Leone MP, Palladino T, Stallone R, Carella M, Palumbo O. Caracterización clínica y molecular de un síndrome de microdeleción del cromosoma 22q13.31 emergente. Am J Med Genet A. febrero de 2018; 176(2):391-398. doi: 10.1002/ajmg.a.38559. Epub 28 de noviembre de 2017. PMID: 29193617.
Feng X, Ye Y, Zhang J, Zhang Y, Zhao S, Mak JCW, Otomo N, Zhao Z, Niu Y, Yonezawa Y, Li G, Lin M, Li X, Cheung PWH, Xu K, Takeda K, Wang S, Xie J, Kotani T, Choi VNT, Song YQ, Yang Y, Luk KDK, Lee KS, Li Z, Li PS, Leung CYH, Lin X, Wang X, Qiu G; Grupo de estudio DISCO (Descifrando trastornos relacionados con la escoliosis y la comorbilidad); Watanabe K; Grupo Japonés de Investigación de Escoliosis de Inicio Temprano; Wu Z, Posey JE, Ikegawa S, Lupski JR, Cheung JPY, Zhang TJ, Gao B, Wu N. Genes de polaridad de células planas centrales VANGL1 y VANGL2 en predisposición a malformaciones vertebrales congénitas. Proc Natl Acad Sci U S A. 30 de abril de 2024; 121(18):e2310283121. doi: 10.1073/pnas.2310283121. Epub 26 de abril de 2024. PMID: 38669183; PMCID: PMC11067467.
Vissarionov S, Schroder JE, Kokushin D, Murashko V, Belianchikov S, Kaplan L. Surgical Correction of Spinopelvic Instability in Children with Caudal Regression Syndrome. Global Spine J (Internet) 2019 (Cited on March 4, 2024); 9(3):260–5. Available at: http://dx.doi.org/10.1177/2192568218779984
Bouchahda H, El Mhabrech H, Hamouda HB, Ghanmi S, Bouchahda R, Soua H. Diagnóstico prenatal del síndrome de regresión caudal y onfalocele en un feto de madre diabética. Pan Afr Med J. 16 de junio de 2017;27:128. doi: 10.11604/pamj.2017.27.128.12041. PMID: 28904658; PMCID: PMC5568004.
National Institute of Perinatology. Manual of Obstetrics Standards and Procedures 2021 (Internet). gob.mx. (Cited on March 4, 2024). Available at: https://www.gob.mx/salud/inper/es/articulos/manual-de-normas-y-procedimientos-de-obstetricia-2021?idiom=es
Pang D. Sacral Agenesis and Caudal Spinal Cord Malformations. Neurosurgery (Internet). 1993 (cited on March 4, 2024);32(5):755–79. Available at: https://pubmed.ncbi.nlm.nih.gov/8492851/
Diabetes gestacional: Impacto de los factores de riesgo en Latinoamérica. Rev Peru Investig Matern Perinat (Internet). 2023 May 24 (cited 2024 Jun. 28);12(1):33-4. Available from: https://investigacionmaternoperinatal.inmp.gob.pe/index.php/rpinmp/article/view/317
Alaa Ibrahim Ali, Wassan Nori, Department of Obstetrics and Gynecology, College of Medicine, Al Mustansiriyah University, Baghdad, Iraq. Gestational Diabetes Mellitus: A Narrative Review. Medical Journal of Babylon (Internet). 2021 (cited on March 4, 2024); (18):163–8. Available at: https://www.iasj.net/iasj/pdf/5a0bdf79b1345482
Sheffield J. Maternal Diabetes Mellitus and Infant Malformations. Obstet Gynecol (Internet). 2002 (cited on March 4, 2024);100(5):925–30. Available at: https://pubmed.ncbi.nlm.nih.gov/12423854/
Basto-Abreu A, López-Olmedo N, Rojas-Martínez R, Aguilar-Salinas CA, Moreno-Banda GL, Carnalla M, Rivera JA, Romero-Martinez M, Barquera S, Barrientos-Gutiérrez T. Prevalence of Prediabetes and Diabetes in Mexico: Ensanut 2022. Salud Publica Mex (Internet). June 13, 2023 (cited on March 4, 2024);65:s163-s168. Available at: https://saludpublica.mx/index.php/spm/article/view/14832.
Reece EA, Homko CJ, Hagay Z. Prenatal Diagnosis and Prevention of Diabetic Embryopathy. Obstet Gynecol Clin North Am (Internet). 1996 (cited on March 4, 2024);23(1):11–28. Available at: https://pubmed.ncbi.nlm.nih.gov/8684774/
Mouraz Mariana, Cominho Joana, Gameiro Cátia, Pauleta Joana, Pedroso Sónia. Caudal Regression Syndrome: A Case of Early Prenatal Diagnosis without Maternal Diabetes. Acta Obstet Ginecol Port (Internet). September 2016 (cited on March 5, 2024); 10(3): 249-252. Available at: http://scielo.pt/scielo.php?script=sci_arttext&pid=S1646-58302016000300009&lng=es
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