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Congenital leukemia is a rare disease that develops from birth to six weeks of life and has a poor prognosis. In addition, a prenatal diagnosis is very difficult if risk factors or abnormal echosonographic findings are absent. We herein report a case of congenital leukemia diagnosed after emergent Cesarean delivery due to the presence of a sinusoidal fetal heart rate (S-FHR). At 36 weeks’ gestation, the mother was admitted to the hospital because of the loss of fetal movement. An S-FHR pattern was observed almost continuously on cardiotocography (CTG), which was categorized as Category III. A male infant weighing 2,884g was delivered by emergent Cesarean section. The Apgar scores at 1 and 5 min were 3 and 6, respectively, but acidemia was not observed (umbilical arterial pH was 7.259). Because the skin color was pale and general petechiae was apparent at delivery, the baby was transferred to the neonatal intensive care unit and a diagnosis of congenital leukemia was made based on the finding of a thorough examination, including severe anemia (Hb=4.2g/dL, Ht=27.6%) When we observe an S-FHR pattern in patients with undetected risk factors, we should consider the possibility of this clinical entity, despite its extreme rarity.

A Sinusoidal FHR Pattern observed in a Case of Congenital Leukemia Diagnosed after Emergent Cesarean Delivery