Fatal outcome following foetal cerebellar haemorrhage associated with placental thrombosis.
Cerebellar haemorrhage is a rare prenatal event. Possible aetiologies for foetal intracranial haemorrhage include: trauma, asphyxia, infection, vascular defects, blood dyscrasias, ingestion of drugs and alloimmune and isoimmune thrombocytopenia. We report the ultrasonographic diagnosis of a cerebellar haematoma at 21 weeks of gestation. The foetus succumbed at 33 weeks of gestation following rupture of a subcapsular liver haematoma. An autopsy demonstrated a placental foetal thrombotic vasculopathy and thrombi in the chorionic vessels. We assume that hypercoagulability was responsible for the multiple infarcts in the foetus with haemorrhagic transformation in the cerebellum and liver. The differential diagnosis of foetal cerebellar haemorrhage includes maternal hypercoagulability; in this case multiple haemorrhagic/ischaemic events may be encountered during the pregnancy. A thorough investigation to elucidate the aetiology is pertinent in every case of foetal cerebellar haemorrhage in order to enable accurate counselling and correct management.
Ultrasound Unit, Department of Obstetrics and Gynecology, The Edith Wolfson Medical Centre, Holon, Israel.
Gustavo
G
Malinger
Neriman
N
Zahalka
Dvora
D
Kidron
Liat
L
Ben-Sira
Dorit
D
Lev
Tally
T
Lerman-Sagie
D000328:Adult; D002526:Cerebellar Diseases / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology; D002824:Chorionic Villi; D005260:Female; D005313:Fetal Death; D005315:Fetal Diseases / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology; D006801:Humans; D020300:Intracranial Hemorrhages / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology; D011247:Pregnancy; D013927:Thrombosis / Q000150:complications* / Q000473:pathology; D016216:Ultrasonography, Prenatal