2 CASES OF MATERNAL ANTENATAL SPLENIC RUPTURE AND HYPOTENSION ASSOCIATED WITH MOEBIUS SYNDROME AND CEREBRAL-PALSY IN OFFSPRING - FURTHER EVIDENCE FOR A UTERO PLACENTAL VASCULAR ETIOLOGY FOR THE MOEBIUS SYNDROME AND SOME CASES OF CEREBRAL-PALSY

We wish to report two cases of congenital abnormality after antenatal car accidents resulting in ruptured spleen and severe hypotension in t he mothers at 8 and 14 weeks gestation. The first case had the classic al Moebius syndrome with 6th and 7th cranial nerve palsy with abnormal brain stem evoked responses, presumably due to hypoxic/ischaemic brai n stem damage and the second case had severe retardation and hypertoni c cerebral palsy which at post mortem was found to be due to old hypox ic/ischaemic lesions to the caudate nucleus putamen and striatum. Conc lusion The cases described provide evidence that severe maternal hypot ension during pregnancy can be associated with lesions to the midbrain and brain stem of offspring. The mechanism is probably utero-placenta l insufficiency, and extrapolation from these two unusual cases would support utero-placental insufficiency as a cause of Moebius syndrome a nd limb deficiency after chorionic villus sampling.