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Foetal hepatic calcification
N D Hawass1, M G el Badawi, J A Fatani
1Department of Radiology, King Saud University Hospital, Kingdom of Saudi Arabia.
Insights
Hepatic calcifications in spontaneously aborted fetuses, including calcified hepatic vein thrombi (CHVT) and calcified portal vein thrombi (CPVT), are linked to severe fetal illnesses and maternal factors. Awareness aids prenatal ultrasound detection.
Area of Science:
- Perinatology
- Fetal Pathology
- Radiology
Background:
- Hepatic calcifications are observed in spontaneously aborted fetuses.
- These calcifications can occur in hepatic veins, portal veins, or parenchyma.
Purpose of the Study:
- To investigate the types and incidence of hepatic calcifications in aborted fetuses.
- To correlate these findings with associated fetal anomalies and maternal factors.
- To assess the potential for prenatal ultrasound detection.
Main Methods:
- Analysis of 1,500 spontaneously aborted fetuses.
- Identification and classification of hepatic calcifications (CHVT, CPVT, parenchymal).
- Confirmation via contrast studies, dissection, and histology.
- Correlation with fetal anomalies and maternal history.
Main Results:
- Thirty-three fetuses (2.2%) exhibited hepatic calcifications.
- Common types included calcified hepatic vein thrombi (CHVT) and calcified portal vein thrombi (CPVT).
- High incidence of associated anomalies (85%), notably meconium intraluminal calcification, cystic hygroma, and metaphyseal defects.
- Maternal factors showed peak incidence in the third decade, with 33% on contraceptive pills and an inverse relationship with gravidity.
Conclusions:
- Severe fetal illnesses likely predispose to CHVT and CPVT.
- Maternal contraceptive pill use and lower gravidity are associated with hepatic calcifications.
- Increased awareness can improve prenatal diagnosis of hepatic calcifications via ultrasound.
Abstract:
Thirty-three cases of 1,500 spontaneously-aborted foetuses showed hepatic calcifications. The exact location of these calcifications were confirmed by contrast studies, anatomic dissection, and further histology when necessary. Of them, 18 were calcified hepatic vein thrombi (CHVT), 12 were calcified portal vein thrombi (CPVT), 2 were parenchymal calcifications, and one was mixed. Associated anomalies were high (85% of cases). No significant difference was found between the type and percentage of anomalies of those with CHVT and those with CPVT. The most common anomalies encountered in all cases were meconium intraluminal calcification (27%), cystic hygroma (18%), and metaphyseal defect (18%). In view of this, it is suggested that a variety of severe foetal illnesses predispose to CHVT and CPVT. At correlation with maternal factors, it was found that the highest incidence was in the third decade. A significant high percentage of mothers (33%) had been on contraceptive pills, and there was interesting inverse relationship of hepatic calcification with gravidity. Practically, it is also hoped that the awareness of the presence of various types of hepatic calcifications will help in their detection prenatally by ultrasound.