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Prenatal diagnosis of porencephaly secondary to maternal carbon monoxide poisoning

Department of Obstetrics and Gynecology, Maternal and Fetal Unit, Istanbul Bakirkoy Women and Children Hospital, Istanbul, Turkey.
Archives of Gynecology (Impact Factor: 1.28). 10/2008; 279(5):697-700. DOI: 10.1007/s00404-008-0776-3
Source: PubMed

ABSTRACT Porencephaly is defined as an area of focal encephalomalacia that communicates with the ventricular system, giving the appearance of a dilated ventricle. It is assumed that vascular occlusion or an infectious process cause gray and white matter necrosis leading to cyst formation in the cerebral parenchyma. Possible etiology of porencephaly includes intracerebral thrombosis, intracranial hemorrhage and fetal infection. We report the first antenatal diagnosis of porencephaly, which apparently resulted from maternal carbon monoxide poisoning.

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    ABSTRACT: Background The poisoning of carbon monoxide (CO) is the leading cause of death by poisoning in France. Its consequences are potentially serious to the fetus. Literature is ancient and little known. Purpose and method Make an inventory of knowledge about carbon monoxide poisoning during pregnancy. Result The CO causes maternal then fetal tissue hypoxia primarily by binding to hemoglobin with which it has a high affinity. Its transplacental passage may cause fetal harm, predominantly in the brain. Severity seems correlated with maternal symptoms during exposure. In the absence of maternal symptoms, however, the available data are reassuring. Hyperbaric oxygen therapy may reduce the risk to the fetus. Discussion Oxygen therapy should be offered in all cases of CO poisoning, especially if there are maternal symptoms during exposure. In addition, a fetal echography directed on the cephalic pole – even a fetal magnetic resonance imaging three weeks after exposure – should also be proposed.
    Journal de Gynécologie Obstétrique et Biologie de la Reproduction 04/2014; 43(4):281–287. DOI:10.1016/j.jgyn.2013.03.002 · 0.62 Impact Factor
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  • [Show abstract] [Hide abstract]
    ABSTRACT: BACKGROUND: The poisoning of carbon monoxide (CO) is the leading cause of death by poisoning in France. Its consequences are potentially serious to the fetus. Literature is ancient and little known. PURPOSE AND METHOD: Make an inventory of knowledge about carbon monoxide poisoning during pregnancy. RESULT: The CO causes maternal then fetal tissue hypoxia primarily by binding to hemoglobin with which it has a high affinity. Its transplacental passage may cause fetal harm, predominantly in the brain. Severity seems correlated with maternal symptoms during exposure. In the absence of maternal symptoms, however, the available data are reassuring. Hyperbaric oxygen therapy may reduce the risk to the fetus. DISCUSSION: Oxygen therapy should be offered in all cases of CO poisoning, especially if there are maternal symptoms during exposure. In addition, a fetal echography directed on the cephalic pole - even a fetal magnetic resonance imaging three weeks after exposure - should also be proposed.
    Journal de Gynécologie Obstétrique et Biologie de la Reproduction 04/2013; · 0.62 Impact Factor

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