OP13.06: Fetal brain anomalies associated with intrauterine neuroinfection and fetal distress and their postnatal results

Abstract

Short oral presentation abstractsby the medial wall of the lateral ventricles and posteriorly by the CS. The structure that forms the AC and PC were more subtle close to 20 weeks, but more evident at an advanced gestational age. Conclusions: Two transabdominal axial planes allow visualization of the AC and PC. Anatomical structures identified in both can be considered as potential new markers for normal midline intrauterine brain development, including the posterior segment of the CC. Objectives: Although intracranial hemorrhage (ICH) is a common event in preterm infants, it may occur in utero as well. Prevalence is approximately 5:10000 pregnancies but only a few cases of prenatal diagnosis by either sonography (US) or magnetic resonance imaging (MRI) have been reported so far. The US appearance of fetal ICH is extremely variable depending upon the site, the severity and the time since it occurred. MRI plays an important role since it adds relevant information on the localization, the presence of ischemic areas and timing of the hemorrhagic event.Prenatally diagnosed ICH has a poor outcome, strongly related to the grade of the lesion. About 40% of fetuses die, and among the survivors, less than half appear neurodevelopmentally normal at short term follow-up. We present a series of 17 cases of ICH prenatally diagnosed, paying special attention to the US and MRI findings, and the clinical outcome. Methods: All cases with an antenatal diagnosis of ICH between 2005 and 2014 and available outcome were included. Results: Most of the cases (82.3%) were identified during a third trimester routine scan at a median gestational age of 30 weeks (range 21-36). The ICH was classified as Grade 1 in 1 case, Grade 3 in 3 cases and Grade 4 in the remaining 13 cases.MRI was performed in 13 cases, being confirmative in all of them regarding grade and location. Six cases ended up with the termination of pregnancy, and 11 fetuses were born alive at term. These were followed up during a mean time of 18 months (range 6-96). Overall some grade of neurologic impairment was observed in 63,6% of the children (n:7;1G3,6G4), mainly mild to moderate motor sequelae. There were no postnatal deaths. Conclusions: Antenatal US allows an accurate diagnosis of fetal ICH. Most of the cases are identified during the third trimester and are of high grade. Conversely to that previously reported, postnatal survival is high but it entails the risk of adverse neurologic outcome in two thirds of the newborns. This information may help the physician in providing patients with prognostic information. Methods: US features of fetal brain detected after anomaly scan were studied and archived in 27 fetuses. The results of neurosonography (NSG) in fetuses with intrauterine neuroinfection (12) and antenatal fetal distress (15) were studied as well as their postnatal MRI and NSG images, postnatal and long-term catamnesis. Adverse general postnatal result (GPR) meant perinatal or infant death, adverse clinical postnatal result (CPR) meant persistent neurologic morbi...

Ultrasound Images and Postnatal Clinical Outcomes in Primary and Secondary Abnormalities of Fetal Brain (Series of 53 Cases)

“…Nowadays, in publications which dedicated to ultrasound in obstetrics a format that represents series of cases with their ultrasound images and clinical features and results is actual [1,2]. It is caused by difficulties of adequate prognosis of postnatal result, though exactly this prediction is the main task of prenatal consultation given to a pregnant woman with suspicion of abnormal development of the fetus central nervous system (CNS).…”

“…Antenatal PVL reports are rarely published. The research results have showed that damage of the white matter of brain is the most important prenatally identifiable risk factor for cerebral paralysis development [6][7][8][9]. The objective of study is the analysis of ultrasound (US) images, clinical perinatal and long-term results in different types of primary and secondary abnormalities of the fetal brain.…”

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“…Nowadays, in publications which dedicated to ultrasound in obstetrics a format that represents series of cases with their ultrasound images and clinical features and results is actual. 1,2 It is caused by difficulties of adequate prognosis of postnatal result, though exactly this prediction is the main task of prenatal consultation given to a pregnant woman with suspicion of abnormal development of the fetus central nervous system (CNS). Such anomalies of fetal CNS as agenesis of the corpus callosum and cortical displasia, found mainly in the second half of pregnancy, after 20-26weeks.…”

“…The research results have showed that damage of the white matter of brain is the most important prenatally identifiable risk factor for cerebral paralysis development. [6][7][8][9] The objective of study is the analysis of ultrasound (US) images, clinical perinatal and longterm results in different types of primary and secondary abnormalities of the fetal brain.…”