Fetal Micrognathia and Airway Establishment on Placental Support

* Abbreviations: ETT: : endotracheal tube EXIT: : ex utero intrapartum treatment POPS: : procedure on placental support A 36-year-old gravida 3, para 2-0-0-2 pregnant woman was referred to our fetal care center at 20 5/7 weeks’ gestation because of fetal micrognathia, lagging femur length, and a single umbilical artery. Her pertinent medical and surgical histories included asthma and a prior cesarean section. The pregnancy was the product of in vitro fertilization. Preimplantation genetic screening demonstrated an embryo with a normal karyotype. Her medications included fluticasone propionate/salmeterol, montelukast, lansoprazole, and prenatal vitamins. Family history revealed 2 paternal female first cousins once removed with Smith-Lemli-Opitz syndrome and seizure disorder related to sodium channelopathy. Her standard prenatal screening results were unremarkable. Evaluation at our fetal care center included the following: Figure 1. Fetal magnetic resonance imaging scan obtained at 20 weeks’ gestation. A. The abnormal facial profile with severe micrognathia. B. Facial profile; white arrow indicates glossoptosis. The conglomeration of these fetal findings is consistent with a diagnosis of Pierre Robin sequence. Pierre Robin sequence occurs …