Gulsah DAGDEVİREN, Elif ERGÜN, Ayşe KELEŞ, Ozge YUCEL CELİK, Aykan YÜCEL, Dilek SAHİN

Fetal intrakraniyal kanama: prenatal görüntüleme bulguları ve postnatal klinik sonuçlar

Amaç: Fetal intrakraniyal kanamanın görüntüleme bulgularını ve postnatal klinik özelliklerini araştırmak. Gereçler ve Yöntem: Çalışmaya kurumumuzda 2018-2020 yılları arasında ultrasonografi ve manyetik rezonans görüntüleme ile tanı konulan fetal intrakranial kanama olguları dahil edildi. Maternal özellikler, ultrason ve manyetik rezonans görüntüleme bulguları ile postnatal sonuçlar hasta kayıtlarından elde edildi. Bulgular: Tanı anında gestasyonel yaşı 21-35 hafta olan toplam 10 olgu tespit edildi. Sekiz fetusta intraventriküler kanama, bir fetusta serebellar kanama ve birinde hem intraventriküler hem de subdural kanama vardı. Olguların %60'ında tanımlanabilir bir risk faktörü saptandı. Ultrasonografi ile yedi fetusta intrakranial kanama tanısı konurken, üç fetusta diğer endikasyonlar için yapılan manyetik rezonans görüntüleme ile fetal intrakranial kanama saptandı. İki olguda gebelik sonlandırıldı, bir adet intrauterin fetal ölüm meydana geldi ve canlı doğan yedi olgu postnatal dönemde en az altı ay süreyle izlendi. Bunların %66,6'sında nörolojik bozukluk görüldü. Sonuç: Manyetik rezonans görüntüleme fetal intrakranial kanamanın tanı ve karakterizasyonunda önemli bir rol oynar ve ultrasonografiyi tamamlayıcıdır. Bu nedenle prenatal tanıda ultrason ve manyetik rezonans görüntüleme birlikte kullanılmalıdır.

Anahtar Kelimeler:

Fetal intrakraniyal kanama, fetal manyetik rezonans görüntüleme, intraventriküler kanama, prenatal tanı, ultrasonografi

Fetal intracranial hemorrhage: prenatal imaging findings and postnatal clinical outcome

Aim: To investigate imaging findings and postnatal clinical features of fetal intracranial hemorrhage. Materials and Method: Fetal intracranial hemorrhage cases detected in our institution between 2018 and 2020 by ultrasonography and magnetic resonance imaging were included. Maternal characteristics, ultrasonography and magnetic resonance imaging findings, and postnatal outcomes were noted. Results: A total of 10 cases with a gestational age of 21-35 weeks at the time of diagnosis were detected. Eight cases had an intraventricular hemorrhage, one case had a cerebellar hemorrhage, and one case had both intraventricular and subdural hemorrhage. An identifiable risk factor was detected in 60% of the cases. While intracranial hemorrhage was diagnosed by ultrasonography in seven cases, in 3 cases it was detected by magnetic resonance imaging that was performed for indications other than intracranial hemorrhage. In two cases pregnancy was terminated, one intrauterine fetal death occurred and seven cases born alive were followed up for at least six months in the postnatal period. Among these, the neurological disorder was observed in 66.6%. Conclusion: Fetal magnetic resonance imaging plays an important role in the diagnosis and characterization of intracranial hemorrhage and is complementary to ultrasonography. Hence we recommend using ultrasonography and magnetic resonance imaging together in its diagnosis.

Keywords:

Fetal intracranial hemorrhage, fetal magnetic resonance imaging, intraventricular hemorrhage, prenatal diagnosis, ultrasonography,

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