Thank you so much for your reply now we have a start to begin to.. We have the CAS (Congenital Anomaly Scan)documents with the signature of the OB-GYN Sonologist and here are his impression to the CAS he ran:
PREGNANCY UTERINE 24 WEEKS AND 2 DAYS BY FETAL BIOMETRY
LIVE, SINGLETON IN BREECH PRESENTATION
POSTERIOR PLACENTA, GRADE 1
ADEQUATE AMNIOTIC FLUID VOLUME
GENDER: MALE
NO GROSS CONGENITAL ANOMALY SEEN AT THE TIME OF SCAN
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But after my sister gave birth to my nephew,my nephew only live for about 12 hrs. and these are his cause of death:
-Respiratory Failure
Antecedent cause:
-diaphragmatic hernia
Underlying cause:
inborn anomaly
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My Nephew's pediatrician ran an X-ray and we were all shocked that the X-ray shows that the heart of my nephew was on the right side and his intestine was on her chest inside to his left lung.
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CDH (CONGENITAL DIAPHRAGMATIC HERNIA) Information from the internet:
Fetal anomaly scan 20-24 weeks
This is a detailed scan during which each part of the fetal body is examined. Special attention is paid to the brain, face, spine, heart, stomach, bowel, kidneys and limbs. If any abnormalities are detected the significance of the findings will be discussed and the couple will be given the opportunity to have further counselling.
20 Week Anomaly Scan
The purpose of this scan is to check development of the baby and it is normally performed at around 20 weeks. Most babies are healthy but sadly some have serious problems, which cannot always be predicted by a family history or the health of the mother. When you attend for this scan we will assume that you wish to know about all problems that are detected by the scan and any concerns that are raised. The scan is performed by a specialist sonographer or doctor. The scan is performed through the tummy wall but occasionally we may need to perform the scan through the vagina if the baby's head is low in your tummy in order to check the developing brain.
The ability to check the baby's development is dependent upon many factors. The bodyweight of the mother and the manner in which the baby lies in the womb are major issues. However, sometimes we cannot obtain what we consider perfect views of a certain part of the baby's body. In this case you will be invited back for a repeat scan. This happens in about 10% of cases so please do not be alarmed if this happens to you. You are only charged for the one visit no matter how many times we need to bring you back.
We can almost always determine the sex of the baby on scanning at 20 weeks but we will only tell you if you wish to know this information.
Over half of all serious congenital malformations can be detected by the 20 week scan. Thus if the baby appears normal on scan there is only a small chance that your baby will have a problem. This is because some problems may not be present at 20 weeks but develop later in the pregnancy e.g. diaphragmatic hernias where there is a small hole in the muscle between the lungs and the bowels.
We have a full counselling service for you should any problems be detected and we will send a copy of our report to your referring hospital, doctor or midwife to ensure good communication between all parties. This is because if we make recommendations on the scan such as a low placenta, this will need a repeat scan again later in the pregnancy to check that it has moved out away from the neck of the womb.
We check the development of the following organs or movements on the anatomy scan: head, brain, face, spine, arms, hands, fingers, heart, lungs, bowels, kidneys, bladder, legs, feet, the fluid around the baby, the umbilical cord and position of the placenta.
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It is very important to find out if there are other problems as well as the CDH. We
would like to do 2 other tests which will give us more information.
1. Amniocentesis
A very fine needle is passed into the womb in order to test the fluid around the
baby. This test will check that the baby has the right number of chromosomes.
There is a very small risk of miscarriage with this test (1/2 to 1%). Results may
take up to 3 weeks. The results of this test are very reliable (99.9%)
2. Echocardiogram
This is a special scan of the baby’s heart. It will tell us if there are any problems
with the heart or the blood vessels around the heart.
If either of these tests show that there is a serious abnormality you will be given
as much information as possible about the chances of the baby surviving and
any special problems the baby may have. You will also have the option of
continuing or ending the pregnancy.
What happens next?
During the pregnancy you will be offered scans every month to check on the
baby’s progress. The doctor will be looking closely at the baby’s lungs to see how
they are growing. It is very important that you keep your usual antenatal
appointments with your midwife or GP. You might like to visit the special care
baby unit to see where your baby will be looked after when he/she is born. You
may find it helpful to talk to the staff there. It is also helpful for you to meet to the
specialist doctor who may be looking after your baby in Alder Hey Hospital.
Advances in fetal medicine have meant that some conditions can be operated on
while the baby is still in the womb. However, this is an area which is still very new
and is currently being evaluated in the United States.
The baby will be delivered around the time when he or she is due. The delivery
will be timed so that the paediatricians are prepared for the arrival of your baby.
Usually these babies are delivered normally unless there are any special reasons
for a caesarian section.
After the delivery the baby is nursed on the special care baby unit. A ventilator
will help the baby to breathe and the baby will need intensive nursing care. A
small percentage of babies may have oxygen given directly into their bloodstream
by a process known as ECMO (Extra Corporeal Membrane Oxygenation). When the baby is well enough he/she will be transferred to Alder Hey children’s hospital.
However, about 10% of all babies born with CDH are too ill to have surgery.
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