Lethal fetal stroke in utero

Abstract

Objective: Fetal intracranial hemorrhage (ICH) in utero is a rare complication of pregnancy associated with subsequent neurological sequelae or fetal death. Case report: A 34-year-old woman with Crohn's disease presented at 36 weeks' gestation due to decreased fetal movement. Fetal heart-rate tracing indicated poor beat-to-beat variability. In addition, a Doppler ultrasonography suggested a prenatal stroke with evidences of ICH, reverse-end diastolic velocity of the middle cerebral artery, and a persistent distended bladder. A nonaggressive treatment option was chosen after counseling about the unfavorable prognosis. However, 22 hours after her admission, intrauterine fetal death occurred. Conclusion: Fetal ICH in utero might be a rare yet lethal complication of Crohn's disease in pregnancy.

Keywords

• Crohn's disease
• fetal cerebral hemorrhage
• fetal intracranial hemorrhage
• fetal intraventricular hemorrhage
• fetal stroke