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Fetal trauma: brain imaging in four neonates
Luc Breysem1, V Cossey, E Mussen
1Department of Radiology, University Hospitals, Herestraat 49, 3000 Leuven, Belgium. luc.breysem@uz.kuleuven.ac.be
European Radiology
|May 25, 2004
Summary
Major traffic trauma in utero can cause severe fetal brain injury, including hemorrhage and hypoxic-ischemic encephalopathy. These injuries significantly impact neonatal survival, highlighting the risks of third-trimester maternal trauma.
Area of Science:
- Neonatal neurology
- Fetal medicine
- Trauma surgery
Background:
- Third-trimester maternal trauma, particularly from traffic accidents, poses risks to fetal development.
- Understanding the spectrum of brain pathology in neonates exposed to in utero trauma is crucial for diagnosis and management.
Observation:
- A cohort of four neonates born after third-trimester maternal car accidents was studied.
- Imaging modalities included cranial ultrasound, computed tomography (CT), and post-mortem magnetic resonance imaging (MRI).
- Clinical outcomes revealed high mortality rates, with all four neonates not surviving.
Findings:
- Brain imaging identified significant pathologies: subarachnoid hemorrhage, subdural hematoma, brain edema, ischemic changes, skull fractures, and intraventricular hemorrhage.
- Post-mortem MRI confirmed cerebellar hemorrhage and cerebral contusions in one case.
- Pathology findings correlated with imaging results, confirming severe cranial injuries.
Implications:
- Blunt abdominal trauma during pregnancy can result in severe fetal cranial injuries.
- Intracranial hemorrhage and hypoxic-ischemic encephalopathy are significant consequences of in utero trauma.
- This study underscores the critical need for prompt recognition and management of fetal head trauma following maternal injury.