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- W4220921156 abstract "A 34-year-old, gravida 2 para 1, Eritrean woman was referred to our Ultrasound Unit for targeted scan due to unexpected finding of fetal dextrocardia during ultrasound assessment of fetal growth at 36 gestational weeks. Her past medical history was significant for human immunodeficiency virus (HIV) infection diagnosed twelve years before. After HIV diagnosis, antiretroviral therapy (ART) including zidovudine, lamivudine and nevirapine was initiated. When this pregnancy occurred ART regimen was switched to tenofovir disoproxil and raltegravir, with an undetectable level of plasma viral load throughout the pregnancy. When the patient was referred to our Unit, ultrasound study showed that fetal heart was displaced to the right in a mesocardial/right paramedian site due to the presence of a homogenous hypoechoic mass occupying nearly half of the left hemithorax, between the left heart ventricle and the left lung (shown in Fig. 1A). Cardiac anatomy was normal. The left lung appeared compressed by the thoracic mass. Given the mediastinal shift, identification of the thymus was challenging. The anatomical landmarks usually employed to localize the fetal thymus (the three-vessel view or so called thy-box between the internal mammary arteries) were not helpful. Since the thymus in its usual appearance was not recognized, aplasia was suspected, while the nature of the chest mass remained uncertain. Examination of the left hemidiaphragm in a sagittal section was technically difficult due to advanced gestational age. We hypothesized a left-sided congenital diaphragmatic hernia with exclusive herniation of the left liver lobe or associated with intrathoracic ectopic liver lobule, which have been described in the literature, although extremely rare conditions. Since ultrasound characterization of the mass was difficult, a fetal magnetic resonance imaging (MRI) was performed. MRI confirmed a medially located heart, slightly displaced to the right, and showed an asymmetric enlargement of the thymus, with uniform signal, in the left mediastinum (shown in Fig. 1B). The diaphragm appeared intact, with a slight supra-elevation of the left hemidiaphragm (shown in Fig. 1C)." @default.
- W4220921156 created "2022-04-03" @default.
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- W4220921156 date "2022-03-01" @default.
- W4220921156 modified "2023-09-27" @default.
- W4220921156 title "Thymic Hyperplasia in A HIV-Exposed Unaffected Fetus" @default.
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- W4220921156 doi "https://doi.org/10.1016/j.ejogrb.2022.03.035" @default.
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