What is the strongest predisposing factor for a stillborn infant with caudal regression syndrome, characterized by a small pelvis, shallow intergluteal cleft, club feet, and absence of the sacrum and lumbar vertebrae, in a 32-year-old woman with no prenatal care?

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Differential Diagnosis for Stillborn Infant with Sacral and Lumbar Vertebrae Absence

  • Single most likely diagnosis
    • Maternal diabetes mellitus: This condition is strongly associated with caudal regression syndrome, characterized by the absence of the sacrum and lumbar vertebrae, as well as other congenital anomalies such as club feet and a small pelvis.
  • Other Likely diagnoses
    • Intrauterine phenytoin exposure: Exposure to phenytoin during pregnancy has been linked to fetal hydantoin syndrome, which can include congenital anomalies such as skeletal abnormalities and growth restriction.
    • Chromosome 13 trisomy: Although less common, trisomy 13 can cause severe congenital anomalies, including skeletal abnormalities, although the specific pattern of sacral and lumbar vertebrae absence is not typically associated with this condition.
  • Do Not Miss
    • Intrauterine infection: Certain infections, such as cytomegalovirus, can cause congenital anomalies and stillbirth, and it is essential to consider and rule out infectious causes to provide appropriate management and counseling.
  • Rare diagnoses
    • Chromosome 18 trisomy: Trisomy 18 is associated with severe congenital anomalies, but the specific pattern of sacral and lumbar vertebrae absence is not typically associated with this condition.
    • Intrauterine alcohol exposure: Fetal alcohol spectrum disorder can cause congenital anomalies, including skeletal abnormalities, but the specific pattern of sacral and lumbar vertebrae absence is not typically associated with this condition.
    • Genetic syndromes: Other rare genetic syndromes, such as spondylocostal dysostosis, can cause congenital anomalies of the spine and skeleton, but these are less likely given the specific pattern of anomalies described.

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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