Question:
What maternal condition is associated with the fetal anomaly shown in the image below?
What maternal condition is associated with the fetal anomaly shown in the image below?
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Absent sacrum: which diabetes is present from before conception?
Updated On: Jun 23, 2026
- ACE inhibitor use
- Gestational diabetes mellitus
- Pregestational diabetes mellitus
- Valproate use
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The Correct Option is C
Solution and Explanation
Answer: Pregestational diabetes mellitus.
The image shows caudal regression syndrome. This rare anomaly is marked by absence of the sacral spine, often with loss of part of the lumbar spine.
The diabetes link: Caudal regression is about 25 times more common in pregnancies complicated by pregestational diabetes, that is, diabetes present before conception, where early poor glycaemic control disrupts caudal mesoderm formation.
Sonographic clues: a short spine that lacks the normal lumbosacral curve and ends abruptly above the iliac wings; because the sacrum is missing between them, the iliac wings sit abnormally close and look 'shield-like'; the lower limbs are abnormally positioned with poor soft-tissue development.
Why not the others: ACE inhibitors cause renal tubular dysgenesis and skull defects; valproate causes neural-tube defects; gestational (not pregestational) diabetes appears later and is far less teratogenic. Ref: Williams Obstetrics, 24th ed, p. 204
The image shows caudal regression syndrome. This rare anomaly is marked by absence of the sacral spine, often with loss of part of the lumbar spine.
The diabetes link: Caudal regression is about 25 times more common in pregnancies complicated by pregestational diabetes, that is, diabetes present before conception, where early poor glycaemic control disrupts caudal mesoderm formation.
Sonographic clues: a short spine that lacks the normal lumbosacral curve and ends abruptly above the iliac wings; because the sacrum is missing between them, the iliac wings sit abnormally close and look 'shield-like'; the lower limbs are abnormally positioned with poor soft-tissue development.
Why not the others: ACE inhibitors cause renal tubular dysgenesis and skull defects; valproate causes neural-tube defects; gestational (not pregestational) diabetes appears later and is far less teratogenic. Ref: Williams Obstetrics, 24th ed, p. 204
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