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Eur J Obstet Gynecol Reprod Biol. 2018 Sep;228:6-12. doi: 10.1016/j.ejogrb.2018.05.044. Epub 2018 Jun 6.

Contribution of fetal brain MRI in management of severe fetal anemia.

Author information

1
CHU Lille, Jeanne de Flandre Hospital, Department of Obstetrics, 59000 Lille, France. Electronic address: louise.ghesquiere@etu.univ-lille2.fr.
2
CHU Lille, Jeanne de Flandre Hospital, Department of Obstetrics, 59000 Lille, France; Univ. Lille North of France, EA4489 - Perinatal Environment and Infant Growth, 59000 Lille, France.
3
CHU Lille, Jeanne de Flandre Hospital, Department of Radiology, 59000 Lille, France.
4
CHU Lille, Department of Neuropediatrics, 59000 Lille, France.
5
CHU Lille, Jeanne de Flandre Hospital, Department of Obstetrics, 59000 Lille, France.

Abstract

INTRODUCTION:

Intrauterine transfusion (IUT) has changed fetal anemia prognosis. However, long-term neurodevelopmental outcome is altered in 5% of children. Our objective was to study the contribution of fetal MRI to diagnosis brain lesions in case of fetal anemia.

MATERIAL AND METHODS:

Retrospective monocentric descriptive study from 2005 to 2016, including all patients followed for fetal anemia requiring IUT. The indications for MRI were: hydrops fetalis and / or hemoglobin <5 g / dL and / or more than 3 IUTs and / or acute severe anemia and / or ultrasound abnormality. Fetal and neonatal outcome and pediatric neurological monitoring were studied.

RESULTS:

89 patients were followed for fetal anemia with IUT and 28 (29.1%) had fetal MRI, 12 of which were abnormal. Two out of twelve had abnormal ultrasound. Seven out of twelve had poor neurological prognosis: 2 medical terminations of pregnancy were performed; 2 children had severe developmental delay and 3 children had schooling difficulties. Five out of twelve children had favorable neurological prognosis.

CONCLUSION:

MRI of the fetal brain makes it possible to better detect brain lesions than ultrasound does in the management of severe fetal anemia and seems particularly appropriate in cases of acute anemia.

KEYWORDS:

Alloimmunization; Fetal brain lesion; Intrauterine transfusion; MRI; Neurological development; Ultrasound

PMID:
29902780
DOI:
10.1016/j.ejogrb.2018.05.044
[Indexed for MEDLINE]

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