Fetal intracranial hemorrhage: is minor maternal trauma a possible pathogenetic factor?

Strigini, Francesca Anna Letizia; Cioni, Giovanni; Canapicchi, R.; Nardini, V.; Capriello, P.; Carmignani, A

doi:10.1046/j.0960-7692.2001.00486.x

Cited by 59 publications

(51 citation statements)

References 31 publications

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“…After that age, the subependymal germinal matrix undergoes a progressive process of involution, which increases the vulnerability of its tenuous capillary network [4]. In our series, all fetuses were diagnosed as having ventriculomegaly by obstetric US at 31–36 weeks of gestation and no abnormal findings were detected by routine US until 27–33 weeks.…”

Section: Discussionmentioning

confidence: 95%

“…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. Strigini et al [4] reported 5 cases of GMIVH, with the similarity of histories involving minor maternal physical trauma in all cases, and they concluded that trauma is at least a contributing factor to the pathogenesis of fetal GMIVH. In our 5 cases, no apparent etiology including maternal trauma could be identified, and the fetuses were appropriate for their gestational age.…”

Section: Discussionmentioning

confidence: 99%

“…Although a number of cases of GMIVH have been detected in utero before the onset of labor with the widespread utilization of obstetric ultrasonographic examination (US) [4], the pathophysiological conditions of fetal GMIVH are still unclear [5]. Thus, we reviewed the clinical and neuroradiological findings of 5 cases with fetal GMIVH.…”

Section: Introductionmentioning

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: 95%

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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“…The causative role of maternal accidents was extremely likely in one patient, and probable but "unproved" in the remaining cases. Another more cogent example is from Strigini et al 15 In five consecutive cases of fetal intracranial hemorrhage, the similarity of histories involving minor maternal physical trauma (three motor vehicle related and two falls), together with the absence of any known factor predisposing to fetal intracranial hemorrhage, suggested that minor trauma was at least a contributing factor to the observed pathology. Other similar but smaller case series or reports have been reported 16 raising the issue of trauma as a true teratogen (defined by the US Environmental Protection Agency as "The introduction of nonhereditary birth defects in a developing fetus by exogenous factors such as physical or chemical agents acting in the womb to interfere with normal embryonic development").…”

Section: Discussionmentioning

confidence: 99%

Characteristics of pregnant women in motor vehicle crashes

Weiss

Strotmeyer²

2002

Inj Prev

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Objectives: Motor vehicle crashes are the leading cause of hospitalized trauma during pregnancy. Maternal injury puts the fetus at great risk, yet little is known about the incidence, risks, and characteristics of pregnant women in crashes. Setting and methods: Police reported crashes were analyzed from the National Automotive Sampling System Crashworthiness Data System. Since 1995, this system recorded pregnancy/trimester status. Pregnant and non-pregnant women 15-39 years of age were compared by age, driver status, seat belt use, and treatment. Belt use and seating position were examined by trimester. Results: There were 427 pregnant occupants identified (weighted n=32 810, 2.6%, SE 12 585, rate 13/1000 person years). The mean age was 24.9 compared with 24.8 years (pregnant v non-pregnant). Cases were distributed by trimester as follows: first 29.8%, second 36.4%, and third 33.8%. Pregnant women were drivers 70% of the time compared with 71% for non-pregnant women. No belt use was 14% compared with 13% (pregnant v non-pregnant). Mean injury severity was lower for pregnant women but they were more likely to transported or hospitalized. Improper belt use decreased after the first trimester and there was little change in driver proportion by trimester. Third trimester hospitalization rates increased. Conclusions: Pregnant occupants in crashes have similar profiles of restraint use, driver status, and seat position but different treatment indicators compared to non-pregnant occupants. Trimester status has relatively little impact on crash risk, seating position or restraint use. Undercounting of pregnant cases was possible, even so, 1% of all births were reported to be involved in utero in crashes. Little research has focused on developmental outcomes to infants and children previously involved in exposure to these crashes.

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“…Therapeutic measures include maternal dietary modification 1 , repeat thoracocentesis 2 , thoracoamniotic shunting 3 , intrapleural injection of maternal blood 4 and pleurodesis with OK-432 5 -9 . We read with interest the articles (two published in 2001 5,6 and one in 2003 7 ) in this journal on pleurodesis using OK-432. The first two cases of our own experience with OK-432 as a therapeutic agent for hydrops fetalis (in one of which it was used for pleurodesis) were published elsewhere 9 .…”

Section: Fetal Ok-432 Pleurodesis: Complete or Incomplete?mentioning

confidence: 99%