Rare complications sometimes occur during pregnancies, interfering with fetal development and growth. They can be attributed to numerous causes such as genetic disorders, fetal chromosomes, and abnormal placenta development. Rosh Maternal & Fetal Medicine provides the best obstetric and gynecological care to women of all ages, for rare complications that may develop during pregnancy.
Selective Intrauterine Growth Restriction (sIUGR)
sIUGR is a rare condition that occurs in identical twin pregnancies. These pregnancies are referred to as monochorionic pregnancies, which suggests that the twins share the placenta as well as a network of blood vessels. The placenta provides nourishment to the unborn children for growth and development in the womb. sIUGR happens when the placenta is not evenly shared between the twins, causing an imbalance of nutrients. If this continues, one twin will become severely malnourished.
sIUGR is diagnosed by a maternal-fetal specialist by studying the results of an ultrasound. The doctor first establishes that the pregnancy is monochorionic, assesses the fetal weight of each twin, and eliminates other causes of fetal weight discrepancies, such as twin-to-twin transfusion syndrome, before confirming the diagnosis.
Congenital Diaphragmatic Hernia (CDH)
CDH occurs when there’s a gap in the diaphragm of a fetus, causing the gut or liver to move into the chest cavity. This takes up space required by the lungs to function properly and might cause respiratory complications. Other aspects of the respiratory system may not develop properly as they will be in a compressed state. If lung underdevelopment is severe, the baby will suffer when it’s born.
CDH may be caused by a genetic disorder or by problems with a baby’s chromosomes. Detection usually happens during an ultrasound exam, which may reveal excess abdominal content in the fetal chest cavity. Doctors will then perform a detailed ultrasound to confirm the prenatal diagnosis of CDH. The doctor will also examine the baby’s chromosomes and measure its lung size. Imaging techniques such as the MRI scan can be used to achieve accurate assessments.
Also referred to as pleural effusion, fetal hydrothorax is a condition where the chest of a fetus is filled with abnormal amounts of fluid, covering the space between or within the core of the lungs. The chest is an enclosed space and presence of fluid can compress the lungs and even displace the heart. Lung compression will interfere with the baby’s development in the womb, and if the heart moves, the fetus will have problems pumping blood and may develop heart failure.
Fetal hydrothorax can be detected through an ultrasound, and if found, the doctor will refer you to a maternal-fetal specialist who will perform a detailed exam known as a fetal echocardiogram. This test will show the severity of the illness and the heart’s condition.
Lower Urinary Tract Obstruction (LUTO)
The urinary tract comprises the kidneys, ureters, urinary bladder, and urethra. The bladder and urethra are part of the lower urinary tract. LUTO is a rare condition that occurs when there’s an obstruction in the urinary tract of a developing fetus. Urine made in the kidneys flows to the bladder where it is stored until it gets full. Once this happens, the bladder pushes urine out of the body through the urethra into the amniotic sac.
When a blockage occurs, all parts of the urinary tract become swollen with urine, which may lead to permanent kidney damage over time. Additionally, when urine is no longer drained, amniotic fluid decreases, leading to lung damage.