Fetal intracranial hemorrhage: sonographic criteria and merits of prenatal diagnosis

Abdelkader, Mohamed; Ramadan, Wafaa; Kamel, Ahmed; Abdelrahman, Rasha W

doi:10.1080/14767058.2016.1245283

Cited by 19 publications

(35 citation statements)

References 21 publications

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“…Known risk factors may be categorized as maternal conditions, obstetric complications, and fetal disorders, such as thrombophilia, fetal–neonatal alloimmune thrombocytopenia, congenital infections, and thrombosis of the umbilical cord . However, in more than 50% of cases, no risk factors are found, and pregnancy management and counseling remain challenging …”

Section: Introductionmentioning

confidence: 99%

“…Fetuses with grade III IVH, with more than 50% of the lateral ventricles filled with blood and ventriculomegaly, as well as those with periventricular hemorrhagic venous infarction or grade IV IVH, have an increased risk of poor postnatal outcome compared with fetuses with IVH limited to the subependymal matrix (grade I) or involving less than 50% of the lateral ventricles (grade II) . The literature also describes other forms of fetal ICH, but with limited topographic data, such as whether the ICH involved the cerebral parenchyma, posterior fossa, subdural, subarachnoid spaces, or choroid plexus hemorrhage …”

Section: Introductionmentioning

confidence: 99%

“…Previous studies have postulated that fetal MRI has a higher sensitivity in detecting ICH compared with fetal US; however, the evolution in appearance of ICH on MRI has not been well described. Therefore, the diagnostic role of MRI compared with US, for these fetal lesions, remains undetermined …”

Section: Introductionmentioning

confidence: 99%

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Fetal intracranial hemorrhage: role of fetal MRI

et al. 2017

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Fetal intracranial hemorrhage: role of fetal MRI

et al. 2017

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“…CFD usually builds on the structural and flow data from CT and MRI. A special mode, tomographic ultrasound imaging (TUI), [14][15][16] provides a depiction of images as a series of slices that can be displayed in x, y, or z planes. [5][6][7][8][9][10] Fetal echocardiography has been used widely in clinical practice to screen and diagnose CHD in fetuses.…”

Section: Introductionmentioning

confidence: 99%

“…Recent application of spatiotemporal image correlation (STIC) [11][12][13] technology in fetal echocardiography has made it possible to acquire 3D/4D gray scale and Doppler images and data in fetuses. A special mode, tomographic ultrasound imaging (TUI), [14][15][16] provides a depiction of images as a series of slices that can be displayed in x, y, or z planes. The TUI images resemble an ultrasound equivalent of CT scan or sectional anatomy, which are particularly suited for 3D/4D modeling of aorta by CFD.…”

Section: Introductionmentioning

confidence: 99%

Modeling of coarctation of aorta in human fetuses using 3D/4D fetal echocardiography and computational fluid dynamics

et al. 2017

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The aortic and ductal arch geometry and flow lead to the alterations in flow profile, velocity, pressure, and WSS in the aortic isthmus in normal and CoA models, which are conductive of ductal issue migration into these areas. A 55% reduction in the dimension of aortic isthmus is associated with exponential change in velocity, pressure, and WSS, a probable threshold for hemodynamically significant CoA.

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Perinatal and long‐term outcome of fetal intracranial hemorrhage: systematic review and meta‐analysis

Sileo

Zöllner

D’Antonio

et al. 2022

Ultrasound in Obstet & Gyne

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Objective Fetal intracranial hemorrhage (ICH) is associated with an increased risk of perinatal mortality and morbidity. Healthcare professionals often find it challenging to counsel parents due to its rarity and diverse presentation. The aim of this systematic review and meta‐analysis was to investigate the perinatal outcome of fetuses with ICH. Methods MEDLINE, EMBASE, http://ClinicalTrials.gov and The Cochrane Library databases were searched. Inclusion criteria were studies reporting the outcome of fetuses, newborns and infants diagnosed with ICH. The primary outcome was perinatal death (PND), defined as the sum of intrauterine (IUD) and neonatal death (NND). The secondary outcomes were stillbirth, NND, IUD, termination of pregnancy, need for surgery/shunting at birth, cerebral palsy (defined according to the European Cerebral Palsy Network and classified as diplegia, hemiplegia, quadriplegia, dyskinetic or mixed), neurodevelopmental delay and intact survival. All outcomes were explored in the included fetuses with ICH. A subgroup analysis according to the location of the hemorrhage (intra‐axial and extra‐axial) was also planned. Meta‐analysis of proportions was used to combine data, and pooled proportions and their 95% CI were reported. Results Sixteen studies (193 fetuses) were included in the meta‐analysis. PND occurred in 14.6% (95% CI, 7.3–24.0%) of fetuses with ICH. Among liveborn cases, 27.6% (95% CI, 12.5–45.9%) required shunt placement or surgery after birth and 32.0% (95% CI, 22.2–42.6%) had cerebral palsy. Furthermore, 16.7% (95% CI, 8.4–27.2%) of cases had mild neurodevelopmental delay, while 31.1% (95% CI, 19.0–44.7%) experienced severe adverse neurodevelopmental outcome. Normal neurodevelopmental outcome was reported in 53.6% of fetuses. Subgroup analysis according to the location of ICH showed that PND occurred in 13.3% (95% CI, 5.7–23.4%) of fetuses with intra‐axial bleeding and 26.7% (95% CI, 5.3–56.8%) of those with extra‐axial bleeding. In fetuses with intra‐axial hemorrhage, 25.2% (95% CI, 11.0–42.9%) required shunt placement or surgery after birth and 25.5% (95% CI, 15.3–37.2%) experienced cerebral palsy. In fetuses with intra‐axial hemorrhage, mild and severe neurodevelopmental delay was observed in 14.9% (95% CI, 12.0–27.0%) and 32.8% (95% CI, 19.8–47.4%) of cases, respectively, while 53.2% (95% CI, 37.0–69.1%) experienced normal neurodevelopmental outcome. The incidence of mortality and postnatal neurodevelopmental outcome in fetuses with extra‐axial hemorrhage could not be estimated reliably due to the small number of cases. Conclusions Fetuses with a prenatal diagnosis of ICH are at high risk of perinatal mortality and adverse neurodevelopmental outcome. Postnatal shunt placement or surgery was required in 28% of cases and cerebral palsy was diagnosed in approximately one‐third of infants. Due to the rarity of ICH, multicenter prospective registries are warranted to collect high‐quality data. © 2021 International Society of Ultrasound in Obstetrics and Gynecology.

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Fetal intracranial hemorrhage: sonographic criteria and merits of prenatal diagnosis

Abstract: Ultrasonography can be used in the detection, classification and monitoring the progression of various types of ICH. TUI is an additional diagnostic tool that might help to detect the exact size, and extent of those lesions. Fetal MRI is not superior, but might aid in the diagnosis.

Cited by 19 publications

References 21 publications

Fetal intracranial hemorrhage: role of fetal MRI

Fetal intracranial hemorrhage: role of fetal MRI

Modeling of coarctation of aorta in human fetuses using 3D/4D fetal echocardiography and computational fluid dynamics

Perinatal and long‐term outcome of fetal intracranial hemorrhage: systematic review and meta‐analysis

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