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Federación Mexicana de Ginecología y Obstetricia, A.C.

2021, Number 09

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Ginecol Obstet Mex 2021; 89 (09)

Is fetal stroke synonim of bad prognosis? Case report and literature review

de Miguel-López C, Gómez-Muñoz LM, Argüello-González A, Serrano-García G, Pérez-Haro MM, Sánchez-Peña JM

Language: Spanish
References: 9
Page: 735-741
PDF size: 446.94 Kb.


ABSTRACT

Background: Prenatal intracranial hemorrhage is rarely detected. The location, size, characteristics, and cause of the bleeding play a decisive role in the pre- and postnatal outcome ranging from normal neurological development to mild cases with spontaneous relief and severe cases with cerebral palsy or intrauterine death. Prenatal counseling, after this diagnosis, should be based on an exhaustive study by a multidisciplinary team.
Clinical case: 33-week gestation fetus with subdural hemorrhage. The study was completed with magnetic resonance imaging and the search for the cause of the bleeding was undertaken. In view of the progress of the lesion, it was decided, in agreement with the parents, to terminate the pregnancy by cesarean section and surgical intervention at birth. The postoperative course was uneventful and the clinical evolution of the newborn up to 15 months of life was normal.
Conclusions: After detection of intracranial hemorrhage, a thorough imaging study should be performed, with evaluation by a multidisciplinary team and a detailed anamnesis to provide correct prenatal advice.


REFERENCES

  1. Abdelkader MA, Ramadan W, Gabr AA, Kamel A, Abdelrahman RW. Fetal intracranial hemorrhage: sonographic criteria and merits of prenatal diagnosis. J Matern Neonatal Med 2017; 30 (18): 2250-56. doi.10.1080/14767058.201 6.1245283

  2. Vergani P, Strobelt N, Locatelli A, et al. Fetus-placentanewborn: Clinical significance of fetal intracranial hemorrhage. Am J Obstet Gynecol 1996; 175 (3 part I): 536-43. doi.10.1053/ob.1996.v175.a73598

  3. Lynch JK, Hirtz DG, DeVeber G, Nelson KB. Report of the National Institute of Neurological Disorders and stroke workshop on perinatal and childhood stroke. Pediatrics 2002; 109 (1): 116-23. doi:10.1542/peds.109.1.116

  4. Griffiths PD, Bradburn M, Campbell MJ, et al. Use of MRI in the diagnosis of fetal brain abnormalities in utero (MERIDIAN): a multicentre, prospective cohort study. Lancet 2017; 389 (10068): 538-46. doi:10.1016/S0140- 6736(16)31723-8

  5. Cheung KW, Tan LN, Seto MTY, Moholkar S, Masson G, Kilby MD. Prenatal diagnosis, management, and outcome of fetal subdural haematoma: A case report and systematic review. Fetal Diagn Ther 2019; 46 (5): 285-95. doi.10.1159/000496202

  6. Ghi T, Simonazzi G, Perolo A, et al. Outcome of antenatally diagnosed intracranial hemorrhage: Case series and review of the literature. Ultrasound Obstet Gynecol 2003; 22 (2): 121-30. doi.10.1002/uog.191

  7. Kutuk MS, Yikilmaz A, Ozgun MT, et al. Prenatal diagnosis and postnatal outcome of fetal intracranial hemorrhage. Child’s Nerv Syst 2014; 30 (3): 411-18. doi:10.1007/s00381- 013-2243-0

  8. Adiego B, Martínez-Ten P, Bermejo C, Estévez M, Recio Rodriguez M, Illescas T. Fetal intracranial hemorrhage. Prenatal diagnosis and postnatal outcomes. J Matern Neonatal Med 2019; 32 (1): 21-30. doi.10.1080/147670 58.2017.1369521

  9. Elchalal U, Yagel S, Gomori JM, et al. Fetal intracranial hemorrhage (fetal stroke): Does grade matter? Ultrasound Obstet Gynecol 2005; 26 (3): 233-43. doi.10.1002/uog.1969




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