Ayesha Arif, Arif Tajammul.
Aplasia Cutis Congenita.
Pak Paed J Jan ;20(4):175-80.

A twenty-two year old primigravida presented for the first time at eighteen weeks of pregnancy. She was seen every month for her amtenatal visits from that time onwards. At twenty-eight weeks she was noticed to have diminished amount of liquor. An ultrasound at this point revealed the liquor index to be 10.2. Weekly antenatals were carried out after this and fetal growth monitored with serial scans. The fetal head and abdominal circumference ratio started to rise in the upper tenth centile range at thirty-six weeks. The estimated fetal weights remained on the lower side. She underwent caesarean section at thirtynine weeks of gestation and a 2.1 kg term female baby was delivered. The Apgar scores were 7 and 9 at one and ten minutes respectively. On detailed examination the baby was found to have a three centimetre diameter oval scalp defect on the right parietal eminence. The underlying parietal bone was also deficient and the meanings were visible through a membrane covering this defect. Paediatric surgery and neurosurgical consults were sought and it was decided to manage this problem conservatively and a barrier dressing of silver sulphadiazine was applied. The baby continued to thrive and was discharged in stable condition along with the mother on the seventh post natal day. The baby was seen again at weekly intervals and the circumference of the defect had gradually started to decrease. It was reduced to lcm diameter by the sixth week and was barely visible by the tenth week. The growth and neurological development of the baby remained normal.

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