Perinatal ultrasonography and magnetic resonance imaging findings in congenital hydrocephalus associated with fetal intraventricular hemorrhage

Fusch, Christoph; Ozdoba, Christoph; Kühn, Peter; Dürig, P.; Remonda, Luca; Müller, Conrad; Kaiser, G; Schroth, Gerhard; Moessinger, Adrien C.

doi:10.1016/s0002-9378(97)70138-8

Cited by 47 publications

(21 citation statements)

References 17 publications

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“…Although GMIVH is a rare event in the fetus, several investigators have detected GMIVH in utero using prenatal US and MRI [9,10,11,12,13,14,15,16,17,18,19,20,21,22]. In several cases, umbilical cord or placental abnormalities [14], maternal pancreatitis [17], maternal pre-eclampsia [11], maternal seizures [20], possible sex-linked disorders [18] and severe thrombocytopenia [18] have been implicated as the initiating factors in the pathogenesis of GMIVH, but in most cases no underlying disease was identified [23, 24]. In our case 1 of twins, only the one of the twins developed GMIVH, suggesting that systemic disorders such as maternal coagulopathies are not considered a significant factor, although fetal ‘focal’ coagulopathy could not be ruled out.…”

Section: Discussionmentioning

confidence: 99%

“…Transabdominal US, which is widely used for detecting fetal brain abnormalities, can demonstrate prenatal intracranial hemorrhage [9, 10, 17, 23], albeit with some limitations [23]. In addition to US, MRI has been used for the diagnosis of GMIVH and in the search of the etiology of IVH [4, 6, 7, 15, 24, 29, 30]. A case has been reported in which a prenatal ICH with IVH was missed on US but was correctly identified by fetal MRI [12].…”

Section: Discussionmentioning

confidence: 99%

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Fetal Germinal Matrix and Intraventricular Hemorrhage

Morioka

Hashiguchi²,

Nagata

et al. 2006

Pediatr Neurosurg

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Subependymal germinal matrix with intraventricular hemorrhage (GMIVH) is a common complication associated with delivery in preterm neonates but has rarely been observed in the fetus. Clinical and neuroradiological findings of 5 patients who were diagnosed as having fetal GMIVH with prenatal ultrasonographic examinations (US) and MRI, and postnatal MRI were reviewed retrospectively. During a seemingly uneventful pregnancy, fetal GMIVH occurred at approximately 30–33 weeks of gestation, with the absence of any known factor predisposing to fetal hemorrhage. Routine obstetric US revealed an intraventricular lesion in the enlarged ventricles. Prenatal MRI clearly demonstrated parenchymal change such as intracerebral hematoma adjacent to the subependymal and intraventricular hematoma, and periventricular leukomalacia as well as GMIVH. Although patients without parenchymal destruction (hemosiderin deposit alone) had a favorable neurodevelopmental outcome, encephalomalacia and periventricular leukomalacia contributed to long-term neurodevelopmental deficits. Evaluating parenchymal damage with prenatal MRI can therefore help to predict neurodevelopmental prognosis of the fetus with GMIVH.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Fetal Germinal Matrix and Intraventricular Hemorrhage

Morioka

Hashiguchi²,

Nagata

et al. 2006

Pediatr Neurosurg

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“…One area in which MRI has proven to be especially beneficial is in evaluation of the fetal CNS (61)(62)(63)(64)(65)(66)(67). Sonographic evaluation of the fetal CNS is limited by: 1) the nonspecific appearance of some anomalies; 2) technical factors that limit resolution of the side of the brain near the transducer; 3) ossification, which obscures visualization of posterior fossa structures; and 4) subtle parenchymal abnormalities that frequently cannot be visualized with ultrasound (68).…”

Section: Cns Anomaliesmentioning

confidence: 99%

Obstetric MRI

Levine

2006

Magnetic Resonance Imaging

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Ultrasound is the imaging modality of choice for pregnant patients. However, MRI is increasingly utilized in patients in whom the sonographic diagnosis is unclear. These include maternal conditions unique to pregnancy such as ectopic pregnancy, placenta accreta, and uterine dehiscence. MRI is also being increasingly utilized in the assessment of abdominopelvic pain in pregnancy, in particular in assessment for appendicitis. Fetal MRI is performed to assess central nervous system (CNS) abnormalities and patients who are considering fetal surgery for conditions such as neural tube defects, congenital diaphragmatic hernia, and masses that obstruct the airway. In the future, functional MRI and fetal volumetry may provide additional information that can aid in our care of complicated pregnancies.

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“…In the presence of congenital hydrocephalus, after excluding major cerebral malformations, a posthemorrhagic cause should be searched [7] . Fetal alloimmune thrombocytopenia should be strongly suspected in the presence of fetal hydrocephalus associated with intracranial hemorrhage and unexplained fetal thrombocytopenia with or without anemia [6,8] .…”

Section: Discussionmentioning

confidence: 99%

Congenital Posthemorrhagic Hydrocephalus: A Case of Fetomaternal Alloimmune Thrombocytopenia

Póvoa

Ramalho²,

Machado³

et al. 2007

Fetal Diagn Ther

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Fetal/neonatal alloimmune thrombocytopenia (NAIT) results from fetomaternal mismatch for human platelet alloantigens leading to antibody-mediated destruction of fetal platelets. This is one of the most common causes of severe thrombocytopenia in the newborn with an incidence of 1/800–1,000. In the most severe cases, NAIT may result in intracranial hemorrhage and may lead to death or neurologic sequelae. We report a case of fetal hydrocephalus caused by NAIT and discuss the importance of making an accurate prenatal diagnosis to improve the management of the current pregnancy and the outcome of subsequent pregnancies. Screening of female siblings of affected cases is recommended in order to detect at-risk individuals.

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Perinatal ultrasonography and magnetic resonance imaging findings in congenital hydrocephalus associated with fetal intraventricular hemorrhage

Cited by 47 publications

References 17 publications

Fetal Germinal Matrix and Intraventricular Hemorrhage

Fetal Germinal Matrix and Intraventricular Hemorrhage

Obstetric MRI

Congenital Posthemorrhagic Hydrocephalus: A Case of Fetomaternal Alloimmune Thrombocytopenia

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