Fetal cerebellar damage in fetuses with severe anemia undergoing intrauterine transfusions

Abstract

A severe anemia seems to put the fetus at risk of cerebellar damage, despite successful intravascular transfusion.

Fetal Brain Injury Associated with Parvovirus B19 Congenital Infection Requiring Intrauterine Transfusion

“…Since the pathophysiological mechanisms of brain injury induced by fetal B19V infection remain unclear in the literature [9,11], our aim was to explore the hypotheses that have been previously suggested: (1) fetal cerebral injuries could be caused by ischemic stroke associated with severe anemia, similar to cases of severe fetal anemia associated with red blood cell alloimmunization [28][29][30]; (2) cerebral injuries could be linked to a direct effect of B19V [19]; and (3) cerebral injuries could be related to hemodynamic changes in cerebral blood flow when IUTs are performed, with sudden high increases in hemoglobin level [11,12].…”

An unusual case of rapidly progressive hemolytic anemia in the late preterm period: case report and literature review

“…4 Furthermore, the survivors can develop medium and long term complications including heart function and morphology alterations 5 or cerebellar lesions, especially in fetuses between 24-32 weeks. 6 The early detection of anemia severity improves prognosis. This has good correlation with Doppler measurement of middle cerebral artery peak systolic velocity (MCA-PSV) due to cerebral vasodilation secondary to hypoxia, 7 but mainly to a reduced viscosity due to low hematocrit.…”

Fetal cerebellar hemorrhage: three cases with postnatal follow‐up

“…Prenatally, however, CBH is a rare event. Although recent advances in prenatal neuroimaging have led to increased recognition of cerebellar lesions in high-risk fetuses, information about the prognostic consequences is limited 4,5 . We report on three cases of isolated fetal CBH, born at our tertiary referral center for antenatal diagnosis and treatment of fetal disorders.…”

“…Despite the fact that there was vermian involvement in Cases 1 and 2, all had unremarkable neurological development at 1-2 years of age. The majority of reports on fetal CBH are described after termination of pregnancy or neonatal death, and therefore information about its prognosis is limited 4,5 . Involvement of the vermis seems to be a risk factor, especially for impaired cognitive function and social behavioral deficits 5 .…”

“…The majority of reports on fetal CBH are described after termination of pregnancy or neonatal death, and therefore information about its prognosis is limited 4,5 . Involvement of the vermis seems to be a risk factor, especially for impaired cognitive function and social behavioral deficits 5 . Findings from our cases suggest that isolated fetal CBH may have a favorable short-term prognosis.…”