Pregnancy in a woman with sacral agenesis from prenatal counseling to delivery: A case report

• Published in: The journal of obstetrics and gynaecology research Vol. 46; no. 5; pp. 784 - 786
• Main Authors: Salsi, Ginevra, Bellussi, Federica, Pilu, Gianluigi, Della Gatta, Anna Nunzia, Youssef, Aly
• Format: Journal Article
• Language: English
• Published: Kyoto, Japan John Wiley & Sons Australia, Ltd 01.05.2020; Wiley Subscription Services, Inc
• Subjects: Abnormalities, Multiple - diagnostic imaging; Abnormalities, Multiple - physiopathology; Adult; Case reports; caudal regression syndrome; Cesarean Section - methods; Female; Fetuses; Humans; Meningocele - diagnostic imaging; Meningocele - physiopathology; Pelvis; pelvis abnormalities; Pregnancy; Pregnancy complications; Pregnancy Complications - diagnostic imaging; Pregnancy Complications - physiopathology; Pregnancy, High-Risk; Prenatal Care - methods; prenatal counseling; sacral agenesis; Sacrococcygeal Region - abnormalities; Sacrococcygeal Region - diagnostic imaging; Sacrococcygeal Region - physiopathology; Sacrum; Ultrasonography, Prenatal; Vertebrae; prenatal counseling; sacral agenesis; pelvis abnormalities; caudal regression syndrome; pregnancy
• ISSN: 1341-8076; 1447-0756
• DOI: 10.1111/jog.14240

Sacral agenesis or CRS (caudal regression syndrome) is a rare congenital condition involving approximately 1 in 25 000 live births (Sharma et al., 2015) and leading to the absence of lower sacral vertebral bodies and severe malformations of the pelvis. This condition is associated with an extreme reduction of the xipho‐pubic distance and of the pelvic dimensions. It is reasonable to think that this might lead to an increased difficulty in obtaining a spontaneous pregnancy and to a consistently increased risk of maternal and perinatal complications. In literature, very little is known about pregnancy in patients with sacral agenesis and therefore on the appropriate way to counsel a patient with this condition who is trying to get pregnant (Greenwell et al., 2013). Although a case of pregnancy in a woman with sacral agenesis is mentioned in a book (J. Rogers, 2006) no cases of women with CRS carrying a pregnancy until a viable age for the fetus are reported in medical literature: as far as we know this is the first case reported in literature of a woman with this condition followed before and throughout the pregnancy with reported pre‐ and perinatal management, leading to a near‐term pregnancy. This case could be useful for clinicians who are requested to counsel female patients with the same condition on the possibility of a pregnancy and possible outcomes.