LAUSR

A 37‐year‐old woman (Gravida 8, Para 7) was referred to our center at 30 weeks gestation due to uncontrolled pregestational diabetes and polyhydramnios. Body mass index was 48 kg/m, and initial hemoglobin A1C was 8.6%. Fetal ultrasound was technically difficult, but detected a horseshoe kidney and a missing lumbar and sacral vertebral column. Low dose CT with 3D reconstruction was performed, confirming the diagnosis of Caudal Regression Syndrome (Figure 1A). A female neonate weighing 3090 g was delivered via cesarean section at 38 weeks, with micromelia, paraplegia, and dysmorphism of the two lower limbs (Figure 1B). Neonatal ultrasound revealed spinal cord ending at the level of a skin dimple in the lower back (circled, Figure 1C). Strict glycemic control is essential before conception since, although rare, sacral agenesis is highly associated with maternal diabetes: 15%–25% of all cases of sacral agenesis occur in the fetuses of women with diabetes. ACKNOWLEDGMENT None