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Prenatal diagnosis and postnatal outcome of fetal intracranial hemorrhage

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Abstract

Background

The aim of this study was to present our experience with six cases of fetal intracranial hemorrhage (ICH) in terms of prenatal diagnostic features, and postnatal outcome.

Methods

The database of prenatal diagnosis unit was searched for antenatally diagnosed ICH cases. Maternal characteristics, ultrasound (US), and magnetic resonance imaging (MRI) findings, clinical course, and postnatal outcome were noted.

Results

We evaluated six consecutive cases of fetal ICH. One case was terminated at 24 weeks, and remaining five cases were delivered between 34 and 38 weeks. Five cases (5/6) had intraventricular, and one (1/6) had intraparenchymal hemorrhage. Hemorrhages were right sided in five cases (5/6), left sided in one case (1/6). Dilated and echogenic ventricular wall were the common US findings. No predisposing factor was detected in four of the cases, and intrauterine growth restriction was an underlying factor in two fetuses. Intrauterine progression of the hydrocephaly, and parenchymal thinning was seen in four cases (4/6). In three of four cases (3/4) with progressive grade 3–4 hemorrhage and hydrocephaly, postnatal outcome were dismal, and one case had mild neurological impairment at three months. In one case which had non-progressive mild ventriculomegaly, the lesion regressed after 4 weeks, and had normal short-term outcome

Conclusion

Fetal ICH can be accurately identified and categorized by antenatal sonography, and fetal MRI. Although intrauterine regression or normal short-term postnatal outcome is possible, the outcome is usually poor for fetuses with high grade and/or progressive lesions. Therefore, further studies assessing long-term postnatal outcome are needed

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Conflict of interest

The authors of this paper declare no conflict of interest.

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Authors and Affiliations

  1. Faculty of Medicine, Department of Obstetrics and Gynecology, Gevher Nesibe Hospital, Erciyes University, 38039, Kayseri, Turkey

    Mehmet Serdar Kutuk, Mahmut Tuncay Ozgun, Mehmet Dolanbay, Semih Uludag, Gulsum Uysal & Mustafa Tas

  2. Faculty of Medicine, Department of Radiology, Erciyes University, Kayseri, Turkey

    Ali Yikilmaz

  3. Faculty of Medicine, Department of Pediatric Neurology, Erciyes University, Kayseri, Turkey

    Mehmet Canpolat

  4. Faculty of Medicine, Department of Pediatric Hematology and Oncology, Erciyes University, Kayseri, Turkey

    Karakukcu Musa

Authors
  1. Mehmet Serdar Kutuk
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  2. Ali Yikilmaz
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  3. Mahmut Tuncay Ozgun
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  4. Mehmet Dolanbay
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  5. Mehmet Canpolat
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  6. Semih Uludag
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  7. Gulsum Uysal
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  8. Mustafa Tas
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  9. Karakukcu Musa
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Corresponding author

Correspondence to Mahmut Tuncay Ozgun.

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This study was not funded by any person or institution.

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Kutuk, M.S., Yikilmaz, A., Ozgun, M.T. et al. Prenatal diagnosis and postnatal outcome of fetal intracranial hemorrhage. Childs Nerv Syst 30, 411–418 (2014). https://doi.org/10.1007/s00381-013-2243-0

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  • DOI: https://doi.org/10.1007/s00381-013-2243-0

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