EP07.03: Prenatal diagnosis and postnatal outcome of fetal intracranial hemorrhage: a single centre 10‐year experience

To assess the prenatal ultrasonographic findings and postnatal outcomes in fetuses with intracranial hemorrhage (ICH). In this retrospective study, we included fetuses prenatally diagnosed with ICH at Severance Hospital between December 2012 and August 2022. Maternal characteristics, prenatal ultrasound findings, and postnatal outcomes were reviewed. We evaluated 22 cases of fetal ICH. Of them, 17 (77.3%) were diagnosed at a median gestational age of 30+6 weeks. The ICH was classified as grade 1-2 in 2 cases, and grade 3-4 in 14 cases. Sixteen (72.7%) cases had intraventricular hemorrhage, 4 cases had subdural hemorrhage, and 2 cases had subarachnoidal hemorrhage combined with intravenricular hemorrhage. 73.7% of grade 3-4 ICH (n = 14) had bilateral and severe ventriculomegaly. The most common prenatal sonographic finding of ICH was progressive ventriculomegaly. Additional sonographic findings included an irregularly shaped choroid plexus, an echogenic intraventricular echogenic clot, and increased periventricular echogenicity. Five cases were lost to follow-up, and 3 intrauterine fetal deaths were noted during the second trimester. The remaining 14 cases were delivered at a median gestational age of 36+4 weeks. These cases were followed up for a median of 33.4 (range, 1 – 79) months. Eight of the 14 cases underwent postnatal extraventricular drainage or ventriculoperitoneal shunt placement. Motor impairment including cerebral palsy was observed in 10 cases (71.4%), developmental delay in 8 (57.1%), and epilepsy in 5 (35.7%). In high-grade fetal ICH, progressive ventriculomegaly might be considered an important ultrasound finding that suggestive of postnatal neurologic impairment.