EP05.27: MRI findings and pregnancy outcome of fetal brain hemorrhagic/ischemic insults

Regarding the importance of hemorrhagic and hypoxic-ischemic damage of the fetal brain and the higher accuracy of MRI, the present study was conducted to investigate the role of MRI and assess pregnancy outcomes. During a retrospective cohort study between 2017 and 2023, we included all hemorrhagic/ischemic brain cases and divided in two groups: group A: fetuses with mild ischemic or hemorrhagic brain damage (Intraventricular hemorrhage (IVH) grade 1 and 2), and group B: those with severe damage (IVH grade 3 and 4 and brain infarction). There were 59 pregnant women with a median age of 26.3 weeks. The most common referral reason for MRI was ventriculomegaly (28 cases). 61% (36) of fetuses were in group A. Among 23 cases in group B, 8 fetuses (13.6%) had brain infarcts in total. More severe forms of ventriculomegaly and also bilateral ventriculomegaly were significantly higher in the group B (p = 0.001). Prenatal death (7 fetuses (33.3%)) postnatal death (5 people (19%)) and live birth with severe disability in 9 neonates (42%) were all observed in group B, except for one case in group A with postnatal death due to trisomy 13. 4 fetuses in group A and 9 fetuses in the group B, had other associated brain anomalies but it was not significant (P > 0.05). 12 fetuses (30%) in group A and 2 fetuses (10%)in group B had no risk factors or associated anomalies. MRI is a very important modality for detecting hemorrhagic/ischemic fetal brain injuries, especially when ultrasound shows non-specific intracranial findings.