Combined measurement of sFlt-1 and PlGF levels can differentiate normal from failed pregnancies, whereas sFlt-1 as well as sFlt-1/PlGF ratio can also discriminate EP from MA. PlGF and Flt-1 gene expression in trophoblasts from women with EP and MA appears impaired.
Aplasia cutis congenita (ACC) is a rare malformation that is characterized by the total absence of all layers of skin at birth. The diagnosis is primarily clinical and the histological appearance varies. 1 Large tissue defects in ACC in the newborn present a management dilemma with no agreement upon method of treatment. Both conservative and surgical approaches to the early management of tissue defects have been reported, with varyingresults. 2 -4 We report the successful conservative treatment of a newborn child suffering from ACC with widespread lower limb involvement and no scalp or truncal involvement or extracutaneous congenital malformations.
Case reportA female infant was born to a 24-year-old woman (gravida II, para II) at 38 weeks gestation. The infant was delivered by cesarean section due to detachment of the right retina in the mother. The newborn's birth weight was 3260 g, length 49 cm, head circumference 33 cm, rectal temperature 36°C and APGAR score 10 at 1 min. The pregnancy was complicated by the death of a monozygotic twin in the 15th week of gestation (fetus papyraceous). The infant was born with congenital absence of the skin that involved the anterior and inner surface of the thighs starting from the inguinocrural folds, the knees, the anterior and inner surface of the fi bula, the medial malleolus, the dorsal surface of the feet up to the head of the fi rst metatarsal, and the calcaneum curea. The skin lesions exhibited a bilateral, symmetrical distribution. A thin translucent membrane covered the skin defect and dermal vessels were easily visible. Serous fl uid exuded from the margins of the skin abnormalities. The remaining skin was thin, dry, and friable and had a tendency to develop fi ssures ( Fig. 1). No associated congenital malformations were demonstrated after a thorough clinical and laboratory examination. No other family members were reported to have similar abnormalities, and no other congenital disorders were found in this patient. Thus, after histopathological confi rmation, the infant was classifi ed as group V according to Frieden's clinical classifi cation of ACC. 5 The present case was defi ned as ACC associated with fetus papyraceous (group V) affecting the lower limbs with no further scalp or truncal involvement or structural abnormalities. The mother did not receive any medication during this second pregnancy and was being attended to at the Obstetrics Department of Ioannina Hospital where she had completed the routine prenatal examinations. The medical management in the present case was decided upon after a thorough physical and laboratory examination of the infant. The infant was closely attended to in aseptic hospital units for 1 week where regular microbiological control was performed and precise antibiotic drug therapy was provided. In cooperation with an orthopedic surgeon, we followed a conservative treatment strategy that included frequent dressing changes. The affected areas were dressed at least once daily with Epigard dressings (Ormed, Freiburg, Germany) and F...
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.