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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Could Be The Reason For Congenital Disorder ?

Initially when my wife(Age: - 32 & First pregnancy, we both are B +ve blood group) went to confirm pregnancy and same time she underwent bleeding, so Dr. confirmed presence of 2 egg cells and out of 2 now 1 is having heart beat and another is do not. So Dr. prescribed “Maintain” injection and “Duphoston” tablet and the injection was continued for 5 month and tablet too was continued for 3 month and more till first TT injection was started. During this period whatever scan was done report was normal and same time blood test , Triple Scan test too was normal. Tiffa Scan performed on Gestation Age 25.7th Week. Following observation was given by Dr. 1) Gross fetal ascites seen We were asked to wait for few week citing a reason saying it can be a transient fetal ascites so may get resolved. Last scan performed on Gestation Age 29.5th Week. Observation where made by Dr. 1) Liquor volume excess AFI-30 2) Estimated foetal weight falls above 95th centile for gestation age. 3) Foetus shows massive ascites (with no internal echoes) 4) Foetal abdominal Cyst of size 28*27MM located posterior to bladder. This time Dr. asked to discontinue with this baby and it was terminated, when baby was born Dr. showed it has a girl baby but baby had male genital organ and female genital part as well. Dr. sent baby for autopsy to Chennai to some fetal disorder autopsy & research center to get the report on what caused this problem. So would like to know what kind of disorder this can be is it a chromosomal, genital disorder? Even deficiency of 21 hydroxylase also can cause similar congenital disorder , is also available on internet. Even it is found that Duphoston table it a banned medicine in country like UK & US but in my wife case she was asked to take for nearly 3 months. Moreover read on internet that hormone like Progesterone if in excess level can also cause similar deformities are what said to be. Injection Maintain also responsible for secreting Progesterone, so what can this medicines & injection cause such problem. In Chennai exactly where it was sent can I get the center name..?
Thu, 12 Jan 2012
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General & Family Physician 's  Response
Hi Devika,

Welcome to HCM.
Initially you had twin gestation out which one aborted very early in the pregnancy where as the other survived with fetal anomalies, which could be detected only later on in the pregnancy and as a precaution the obstetrician waited for some more time, before advising termination of pregnancy.
Most likely both the fetuses had congenital anomalies in which one of the fetuses was not at all compatible with life so aborted in the initial stages itself wheres as the other fetus continued for some more time. These are most likely to be genetic disorders, though many other anoomalies could lead to fetal ascites. The drugs duphaston and maintain are routinely used by numerous obstetricians throughout India and these abnormalites due to the drugs have not been reported.
I think the centre where the fetus was sent for genetic study could be MediScan,of Dr. Suresh.
Wish you best of every thing.
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What Could Be The Reason For Congenital Disorder ?

Hi Devika, Welcome to HCM. Initially you had twin gestation out which one aborted very early in the pregnancy where as the other survived with fetal anomalies, which could be detected only later on in the pregnancy and as a precaution the obstetrician waited for some more time, before advising termination of pregnancy. Most likely both the fetuses had congenital anomalies in which one of the fetuses was not at all compatible with life so aborted in the initial stages itself wheres as the other fetus continued for some more time. These are most likely to be genetic disorders, though many other anoomalies could lead to fetal ascites. The drugs duphaston and maintain are routinely used by numerous obstetricians throughout India and these abnormalites due to the drugs have not been reported. I think the centre where the fetus was sent for genetic study could be MediScan,of Dr. Suresh. Wish you best of every thing.