Fetal intracranial hemorrhage. Prenatal diagnosis and postnatal outcomes

Abstract

Diagnosis of fetal ICH is amenable to antenatal US. Most of the cases identified are of high grade and usually detected during the third trimester. MRI is a valuable complementary tool in evaluating ICH. Conversely to that previously reported, postnatal survival is high but it entails the risk of adverse neurologic outcome in most neonates.

Antenatal diagnosis of fetal intraventricular hemorrhage: systematic review and meta‐analysis

“…A total of 80 articles describing 240 cases were included 16,17,19–96 . The search of MEDLINE and Embase provided a total of 14 991 records, with three additional records identified by hand searching (Fig.…”

Dedicated neurosonography for recognition of pathology associated with mild‐to‐moderate ventriculomegaly

“…); under these circumstances, an external version can be considered and, if this fails, MRI may be indicated. Sequential follow‐up with third‐trimester neurosonographic assessment could also be considered to diagnose developmental findings that may appear only later in pregnancy but are significant for differential diagnosis and prognostication. Some of the conditions that may go undiagnosed by routine US, such as intracranial hemorrhage (Figures 1 and 2), callosal anomalies (Figure 3) and malformations of cortical development (Figure 4), may be diagnosed by neurosonography and have been reported in several clinical studies 16–23 . The reasons for the diagnostic failure by US of these conditions are not discussed in the ENSO study 15 .…”

“…Following ultrasound diagnosis, additional MRI was performed at 32 + 6 weeks, which also showed IVH (d). reported in several clinical studies [16][17][18][19][20][21][22][23] . The reasons for the diagnostic failure by US of these conditions are not discussed in the ENSO study 15 .…”

Worm Sign: A possible first‐trimester sonographic marker for intracranial haemorrhage resulting in significant cortical disruption

“…1 ICH is associated with poor neurologic outcomes in the neonate, including psychomotor delays, cerebral palsy, postnatal seizure disorders, and intellectual disabilities. 2 For these reasons, prenatal diagnosis of ICH is crucial for prenatal counselling, antenatal surveillance, and immediate postnatal neurosurgical evaluation to optimise outcomes and quality of life.…”

“…Though the incidence is low, findings of ICH are not usually detected until the second and earlythird trimesters. 2 No cases of first-trimester prenatal diagnosis of ICH have been described. We report a case of a singleton pregnancy in which fetal ICH of unknown aetiology was diagnosed at 13 weeks and 5 days during the first-trimester ultrasound.…”