Jessica Nyholm

P28.18: Elusive diagnosis of pregnancy in non‐communicating rudimentary horn

karyogram: 47XX+16. Amniocentesis showed a 46XX karyogram with normal chromosomes 16. Analysis for uniparental disomy (UPD) proved negative. 2D and 3D US examinations revealed no structural anomalies and normal foetal Dopplers. Growth however remained below the p2.3. The mother developed pregnancy-induced hypertension. At 37 weeks a female infant was born, birth weigth of 2010 grams (< P2.5). After birth, growth climbed to the p50 in the first 2 months and remained there. No congenital abnormalities were found. Discussion: In embryos surviving the 1st trimester trisomy 16 is in almost all cases mosaic. Increased frequency of trisomic cells in the placenta is believed to result in impaired placentation and subsequent intra-uterine-growth-restriction (IUGR). In this patient serum PAPP-A levels were extremely low. This has been associated with a number of adverse pregnancy outcomes, such as increased risk of pre-eclampsia, gestational hypertension and IUGR. To our knowledge, this is the first report describing low serum PAPP-A level in association with placental confined trisomy 16. Interestingly, IUGR was already observed in the embryonic period in the I-Space VR System.