Fetal Germinal Matrix Hemorrhage: Prenatal Diagnosis and Management

We report a case of germinal matrix intraventricular hemorrhage (GMIVH) diagnosed antenatally at 30  weeks of gestation. The pregnancy was continued with close monitoring up to 37 weeks of gestation. A healthy baby was delivered and had normal neurological development after 8 months of postnatal follow-up. GMIVH, though common in premature neonates, is rarely seen in fetal life. Diagnosis is po ssible by prenatal ultrasound usually in the third trimester. Tomographic ultrasound imaging is a useful alternative to fetal MRI in assessing the extent of parenchymal involvement. The findings on imaging studies can elude the correct diagnosis if the lesion is not observed over a period of time an d can often be misdiagnosed as choroid plexus tumors. Severe hemorrhage with gross hydrocephalus can impair the neurological development of the child. However, if the hemorrhage is confined to the ventricles and there is no serious underlying etiology, it is likely to resolve spontaneously leaving n o significant neurological sequelae. Counseling the parents is of utmost importance to avoid any medico-legal issues.
Source: Journal of Fetal Medicine - Category: Perinatology & Neonatology Source Type: research