Rationale: Fetal intracranial hemorrhage (ICH) is an extremely rare complication of pregnancy, with subsequent neurological sequelae or fetal death. The diagnosis of fetal ICH is primarily based on ultrasound or magnetic resonance imaging.
Patient Concerns: An asymptomatic woman at 31 weeks of gestation was referred for a detailed anomaly scan because routine fetal ultrasonography showed suspected fetal ICH.
Diagnoses: Fetal ICH with extensive and multifocal hemorrhagic lesions was diagnosed by ultrasound and magnetic resonance imaging imaging and finally confirmed by postmortem examination.
Interventions: The woman opted for pregnancy termination after medical consultation. Labor was induced by mifepristone and rivanol infusion.
Outcomes: The patient delivered a stillborn male infant weighing 1522 g. We tried our best to screen the possible etiology contributing to fetal ICH; unfortunately, no evidence of obvious causes or predisposing factors was identified.
Lessons: Medically unexplained massive fetal ICH may cause an unfavorable prognosis, and prompt termination of pregnancy is appropriate, although there is no consensus on the optimal mode of delivery.
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http://dx.doi.org/10.1097/MD.0000000000029335 | DOI Listing |
Heliyon
December 2024
Department of Radiology, Obstetrics and Gynecology Hospital, Fudan University, PR China.
Objectives: To clarify the prenatal magnetic resonance (MR) imaging characteristics of fetal intracranial haemorrhages (ICHs) in a large cohort and correlate them with birth outcomes.
Methods: We retrospectively reviewed MR images of fetuses with ICH on screening ultrasound (US) on picture archiving communication system (PACS) servers within a nearly ten-year period from two medical tertiary centres. The indications, main abnormal findings and coexistent anomalies were recorded by two experienced radiologists with census readings.
Pediatr Res
January 2025
Center for Genetic Medicine, Children's National Research Institute, Washington, DC, USA.
Background: Prenatally transmitted viruses can cause severe damage to the developing brain. There is unexplained variability in prenatal brain injury and postnatal neurodevelopmental outcomes, suggesting disease modifiers. Of note, prenatal Zika infection can cause a spectrum of neurodevelopmental disorders, including congenital Zika syndrome.
View Article and Find Full Text PDFEur J Pediatr
January 2025
Neonatology Department. Hospital Sant Joan de Déu, Center for Maternal Fetal and Neonatal Medicine. Neonatal Brain Group, Universitat de Barcelona. Hospital Clínic, Universitat de Barcelona. BCNatal - Barcelona, Institut de Recerca Sant Joan de Déu, Barcelona, Spain.
Purpose: Perinatal hypoxic-ischemic encephalopathy (HIE) is a significant cause of neonatal brain injury. Therapeutic hypothermia (TH) is the standard treatment for term neonates, but its safety and efficacy in neonates < 36 weeks gestational age (GA) remains unclear. This case series aimed to evaluate the outcomes of preterm infants with HIE treated with TH.
View Article and Find Full Text PDFBackground: Malaria prevention during pregnancy significantly minimizes maternal-fetal adverse events. However, optimal uptake of malaria preventive therapy in pregnancy (MPTp) remains a major challenge for both women living with HIV and those without. In Uganda, suboptimal uptake of MPTp is primarily due to inadequate knowledge among women.
View Article and Find Full Text PDFVox Sang
December 2024
Department of Biomedical Data Sciences, Section Medical Decision Making, Leiden University Medical Center, Leiden, the Netherlands.
Background And Objectives: Foetal and neonatal alloimmune thrombocytopenia (FNAIT) results from maternal platelet-directed antibodies and can result in severe intracranial haemorrhage (ICH) in foetuses and newborns. Screening for human platelet antigen-1a (HPA-1a)-directed antibodies during pregnancy could allow timely intervention with antenatal treatment and prevent ICH. We assessed the cost effectiveness of HPA-1a typing and anti-HPA-1a-screening as part of the prenatal screening programme.
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