Intraventricular Hemorrhage in a Single Fetus of Dichorionic-Diamniotic Gestation: A Case Report and Review of Literature

Abstract

Intraventricular hemorrhage (IVH) is a serious complication of prematurity and is of high concern due to the risk of brain injury and in severe cases, death. We report the first case of IVH in a fetus of dichorionic-diamniotic pregnancy that worsened postnatally. Antenatally, magnetic resonance imaging confirmed a large IVH after ventricular abnormalities were detected by prenatal ultrasound (US). At birth, a grade IV IVH diagnosis was made and progressive ventricle dilatation was noted on weekly US. A ventriculoperitoneal shunt was placed and ventricle dilatation was slightly reduced, however, the IVH was essentially unchanged. The infant was discharged in stable condition at 12-weeks-old and chronic neurological dysfunction is expected. IVH is seen in complicated births of prematurity and antenatal US can inform an examiner if fetal IVH is present. It is important to identify IVH and provide immediate intervention to prevent disease worsening during the antenatal and postnatal period.