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Article: Prenatal Diagnosis, Management, and Outcome of Fetal Subdural Haematoma: A Case Report and Systematic Review

TitlePrenatal Diagnosis, Management, and Outcome of Fetal Subdural Haematoma: A Case Report and Systematic Review
Authors
KeywordsIntracranial haemorrhage
Haematoma
Subdural haematoma
Pregnancy
Ultrasonography
Issue Date2019
PublisherS Karger AG. The Journal's web site is located at http://www.karger.com/FDT
Citation
Fetal Diagnosis and Therapy: clinical advances and basic research, 2019, v. 46, p. 285-295 How to Cite?
AbstractBackground: Fetal subdural haematoma (SDH) is associated with poor prognosis. Objective: The conflicting evidence from the literature presents a challenge in prenatal counselling. We present a case study and systematic review of the literature for the management and outcome of fetal SDH. Methods: Systematic search of electronic database. Results: A total 45 cases were extracted from 39 papers. Prenatal ultrasonographic features were intracranial echogenicity (42%), lateral ventriculomegaly (38%), presence of an intracranial mass (31%), macrocephaly (24%), midline deviation of cerebral falx (20%), and intracranial fluid collection (11%). Further secondary features were noted including reversed diastolic flow in the middle cerebral artery (11%), echogenic bowel (4%), hydrops fetalis (2%), and elevated middle cerebral artery peak systolic velocity (2%) (all highly likely to be associated with fetal anaemia). The rates of termination of pregnancy, stillbirth, and neonatal death were 18% (8/45), 16% (7/45), and 11% (5/45), respectively. Overall, therefore, the fetal and perinatal mortality was 32% (12/37). Amongst the 24 survivors with available neurological outcome, 42% (10/24) and 58% (14/24) had abnormal and normal neurological outcome, respectively. Underlying aetiology of fetal SDH was not identified in 47% (21/45). Fetal SDH with an identifiable underlying aetiology was the only factor associated with a higher chance of normal neurological outcome when compared to fetal SDH without a detectable cause (78.5 vs. 21.4%, p = 0.035). Conclusions: Stillbirth and neonatal death occurred in a significant proportion of fetal SDH. 58% of survivors had normal neurological outcome, and better prognosis was seen in SDH with identifiable underlying aetiology. © 2019 S. Karger AG, Basel
Persistent Identifierhttp://hdl.handle.net/10722/269482
ISSN
2019 Impact Factor: 2.095
2015 SCImago Journal Rankings: 1.901

 

DC FieldValueLanguage
dc.contributor.authorCheung, KW-
dc.contributor.authorTan, LN-
dc.contributor.authorSeto, MTY-
dc.contributor.authorMoholkar, S-
dc.contributor.authorMasson, G-
dc.contributor.authorKilby, MD-
dc.date.accessioned2019-04-24T08:08:37Z-
dc.date.available2019-04-24T08:08:37Z-
dc.date.issued2019-
dc.identifier.citationFetal Diagnosis and Therapy: clinical advances and basic research, 2019, v. 46, p. 285-295-
dc.identifier.issn1015-3837-
dc.identifier.urihttp://hdl.handle.net/10722/269482-
dc.description.abstractBackground: Fetal subdural haematoma (SDH) is associated with poor prognosis. Objective: The conflicting evidence from the literature presents a challenge in prenatal counselling. We present a case study and systematic review of the literature for the management and outcome of fetal SDH. Methods: Systematic search of electronic database. Results: A total 45 cases were extracted from 39 papers. Prenatal ultrasonographic features were intracranial echogenicity (42%), lateral ventriculomegaly (38%), presence of an intracranial mass (31%), macrocephaly (24%), midline deviation of cerebral falx (20%), and intracranial fluid collection (11%). Further secondary features were noted including reversed diastolic flow in the middle cerebral artery (11%), echogenic bowel (4%), hydrops fetalis (2%), and elevated middle cerebral artery peak systolic velocity (2%) (all highly likely to be associated with fetal anaemia). The rates of termination of pregnancy, stillbirth, and neonatal death were 18% (8/45), 16% (7/45), and 11% (5/45), respectively. Overall, therefore, the fetal and perinatal mortality was 32% (12/37). Amongst the 24 survivors with available neurological outcome, 42% (10/24) and 58% (14/24) had abnormal and normal neurological outcome, respectively. Underlying aetiology of fetal SDH was not identified in 47% (21/45). Fetal SDH with an identifiable underlying aetiology was the only factor associated with a higher chance of normal neurological outcome when compared to fetal SDH without a detectable cause (78.5 vs. 21.4%, p = 0.035). Conclusions: Stillbirth and neonatal death occurred in a significant proportion of fetal SDH. 58% of survivors had normal neurological outcome, and better prognosis was seen in SDH with identifiable underlying aetiology. © 2019 S. Karger AG, Basel-
dc.languageeng-
dc.publisherS Karger AG. The Journal's web site is located at http://www.karger.com/FDT-
dc.relation.ispartofFetal Diagnosis and Therapy: clinical advances and basic research-
dc.rightsFetal Diagnosis and Therapy: clinical advances and basic research. Copyright © S Karger AG.-
dc.rightsThis is the peer-reviewed but unedited manuscript version of the following article: [insert full citation, e.g., Cytogenet Genome Res 2014;142:227–238 (DOI: 10.1159/000361001)]. The final, published version is available at http://www.karger.com/?doi=[insert DOI number]. OR This is the un-reviewed and unedited manuscript version of the following article: [insert full citation, e.g., Cytogenet Genome Res 2014;142:227–238 (DOI: 10.1159/000361001)]. The final, published version is available at http://www.karger.com/?doi=[insert DOI number].-
dc.subjectIntracranial haemorrhage-
dc.subjectHaematoma-
dc.subjectSubdural haematoma-
dc.subjectPregnancy-
dc.subjectUltrasonography-
dc.titlePrenatal Diagnosis, Management, and Outcome of Fetal Subdural Haematoma: A Case Report and Systematic Review-
dc.typeArticle-
dc.identifier.emailCheung, KW: kawang@hku.hk-
dc.identifier.emailSeto, MTY: mimiseto@hku.hk-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1159/000496202-
dc.identifier.pmid30861511-
dc.identifier.scopuseid_2-s2.0-85063456196-
dc.identifier.hkuros297489-
dc.identifier.volume46-
dc.identifier.spage285-
dc.identifier.epage295-
dc.publisher.placeSwitzerland-

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