Congenital Leukemia: An Unusual Cause of Fetal Distress

Abstract

An emergent cesarean delivery was performed on a 28-year-old nullipara following a non-reactive nonstress test, reports of absent fetal movement, and the ultrasonic observation of hydramnios and fetal organomegaly. Histologically, immature myeloid leukemic cells were observed invading the dermis, viscera, and peripheral blood of the resulting 3,250-g female infant. Laboratory testing and histologic examination excluded known causes of neonatal leukemoid reaction. Chromosomal studies revealed a normal somatic cell line, 46,XX, and an abnormal cell line in the malignant cells, 46,XX,t(l;16)(p13;q14). The differential diagnosis of congenital leukemia and implications for obstetric management are discussed.

Key Words:

• Congenital leukemia
• Prenatal diagnosis
• Hydramnios
• Ultrasonography
• Fetal distress