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Fetal Leukemia With Umbilical Artery Embolism and Circulatory Failure

Shibasaki, Tomoko MD1; Matsuda, Hideo MD1; Kawakami, Yuichi MD1; Furuya, Kenichi MD1

doi: 10.1097/01.AOG.0000232508.77614.6d
Case Reports
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BACKGROUND: This is a case report of fetal leukemia associated with hydramnios.

CASE: When the hydramnios was treated with amnioreduction, near-term bradycardia was recorded ultrasonographically, resulting in immediate cesarean delivery. At birth, neonatal leukemia was diagnosed and there was no evidence of chromosomal abnormalities. The infant died of pulmonary hemorrhage. Autopsy showed umbilical venous embolization with tumor cells, and there was arterial invasion of the vessel wall by tumor.

CONCLUSION: Fetal leukemia is extremely rare, and its prenatal diagnosis is difficult. In cases of hepatomegaly, fetal leukemia should be considered in the differential diagnosis.

This article presents a rare case of umbilical artery embolism in fetal leukemia causing sudden fatal circulatory failure, which was recorded ultrasonographically.

From the 1Department of Obstetrics and Gynecology, National Defense Medical College, Saitama, Japan.

Corresponding author: Tomoko Shibasaki, MD, Department of Obstetrics and Gynecology, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama, 359-8513, Japan; e-mail: tom-s@momo.so-net.ne.jp.

© 2007 The American College of Obstetricians and Gynecologists