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Sirenomelia: A Multi‐systemic Polytopic Field Defect with Ongoing Controversies
Author(s) -
Boer Lucas L.,
Morava Eva,
Klein Willemijn M.,
SchepensFranke Annelieke N.,
Oostra Roelof Jan
Publication year - 2017
Publication title -
birth defects research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.845
H-Index - 17
ISSN - 2472-1727
DOI - 10.1002/bdr2.1049
Subject(s) - etiology , context (archaeology) , genitourinary system , medicine , anatomy , biology , pathology , paleontology
The most impressive phenotypic appearance of sirenomelia is the presence of a 180°‐rotated, axially positioned, single lower limb. Associated gastrointestinal and genitourinary anomalies are almost always present. This rare anomaly is still the subject of ongoing controversies concerning its nosology, pathogenesis, and possible genetic etiology. Sirenomelia can be part of a syndromic continuum, overlapping with other complex conditions including caudal dysgenesis and VATER/VACTERL/VACTERL‐H associations, which could all be part of a heterogeneous spectrum, and originate from an early defect in blastogenesis. It is imaginable that different “primary field defects,” whether or not genetically based, induce a spectrum of caudal malformations. In the current study, we review the contemporary hypotheses and conceptual approaches regarding the etiology and pathogenesis of sirenomelia, especially in the context of concomitant conditions. To expand on the latter, we included the external and internal dysmorphology of one third trimester sirenomelic fetus from our anatomical museum collection, in which multiple concomitant but discordant anomalies were observed compared with classic sirenomelia, and was diagnosed as VACTERL‐H association with sirenomelia. Birth Defects Research 109:791–804, 2017. © 2017 The Authors. Birth Defects Research Published by Wiley Periodicals, Inc.

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