Cukurova Medical Journal Cukurova Med J 2017;42(2):376-379 ÇUKUROVA ÜNİVERSİTESİ TIP FAKÜLTESİ DERGİSİ DOI: 10.17826/cutf.323095 Yazışma Adresi/Address for Correspondence: Dr. Mekin Sezik, Süleyman Demirel University, Faculty of Medicine, Department of Obstetrics and Gynecology, Division of Perinatology, Isparta, Turkey E-mail: msezik@yahoo.com Geliş tarihi/Received: 15.08.2016 Kabul tarihi/Accepted: 28.09.2016 OLGU SUNUMU / CASE REPORT Prenatal diagnosis of rare co-occurrence of congenital diaphragmatic hernia and aortic coarctation Konjenital diafragmatik herni ve aortik koarktasyon nadir birlikteliğinin prenatal tanısı Mehmet Özgür Akkurt 1 , And Yavuz 1 , Serenat Eriş Yalçın 1 , İltaç Akkurt 2 , Mekin Sezik 1 1 Süleyman Demirel University, Faculty of Medicine, Department of Obstetrics and Gynecology, Isparta, Turkey. 2 Isparta Maternity and Children’s Hospital, Department of Obstetrics and Gynecology, Isparta, Turkey. Cukurova Medical Journal 2017;42(2):376-379 Abstract Öz Congenital diaphragmatic hernia is a common thoracic abnormality with increased risk of associated abnormalities. The etiology of congenital diaphragmatic hernia is not exactly known and the plausible reason is the defect of the amuscular component of the primordial diaphragm. Although, fetal heart abnormalities are the most common associated abnormalities in fetuses with congenital heart defect, aortic coarctation is occurred rarely. We present a case with the prenatal diagnosis of the co-occurrence of congenital diaphragmatic hernia and aortic coarctation. Konjenital diafragmatik herni eşlik edebilecek diğer organ anomalileri riskinin arttığı, sık görülen bir toraks anomalisidir. Kesin etyolojisi bilinmemekle beraber, olası nedeni primordiyal diafragmanın amuskuler parçasındaki kusurdur. Konjenital diafragmatik hernili fetuslarda en sık birliktelik gösteren anomalisi kalp anomalisi olmakla beraber, aortic koarktasyon nadir görülmektedir. Bu olguda konjenital diafragma hernisi ve aortic koarktasyonu nadir birlikteliğinin prenatal tanısı sunulmuştur. Key words: Aortic coarctation, congenital diaphragmatic hernia, prenatal diagnosis. Anahtar kelimeler: Aort koarktasyonu, konjenital diafram hernisi, prenatal tanı. INTRODUCTION Fetal congenital diaphragmatic hernia (CDH) is a life-threatening anomaly with an incidence of around 1/2500 live births 1 . CDH has been observed to be associated with smoking, vitamin A deficiency, alcohol and anticonvulsant exposure 2 . The most common associated chromosomal anomaly is trisomy 21 followed by trisomy 18 and 13 2 . CDH may be isolated or associated with malformations that includes cardiovascular (52%), urogenital (23%), gastrointestinal (14%), and central nervous (10%) systems 3 . Here, we report the prenatal diagnosis of a rare co-occurrence of CDH and left ventricular outflow tract obstruction. Although the combination of these 2 anomalies has been reported before, authors were not able to diagnose the aortic coarctation prenatally 4,5 thus, we emphasize in the present case the diagnostic difficulties and management options such as pregnancy termination. CASE A 27-year-old primigravida was referred for evaluation of fluid filled mass in the fetal thorax that was seen on routine second trimester ultrasonography (US) at 21 weeks’ gestation. Her obstetric history was unremarkable. Detailed US of the fetus (Voluson 730; General Electric, Tiefenbach, Austria) showed fluid filled stomach and liver herniated to left chest cavity. Fetal hepatic vessels were visualised by colour Doppler examination to confirm liver herniation (Figure 1a). Moreover, fetal heart was identified in the right