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Case Reports in Obstetrics and Gynecology
Volume 2018, Article ID 1465034, 4 pages
https://doi.org/10.1155/2018/1465034
Case Report

Delayed Appearance of a Traumatic Fetal Intracranial Hemorrhage

Department of Obstetrics, Gynecology, and Women’s Health, University of Hawaii John A Burns School of Medicine, Honolulu, HI, USA

Correspondence should be addressed to Kelly Yamasato; ude.iiawah@tasamayk

Received 15 September 2017; Accepted 1 February 2018; Published 27 February 2018

Academic Editor: Erich Cosmi

Copyright © 2018 Kelly Yamasato et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Fetal intracranial injury is a potentially devastating sequelae of maternal trauma, but there is little guidance regarding fetal evaluation in this setting. Case. A 23-year-old woman at 27-week gestation was admitted after a high-speed motor vehicle accident. The initial obstetrical ultrasound was unremarkable, but persistently minimal fetal heart rate variability was observed. Ultrasound on day 3 after the accident showed an intracranial hyperechogenic lesion and subdural fluid collection. The neonate, following an uneventful birth at 39 weeks, had seizures and abnormal muscle tone. MRI was consistent with in utero intracranial hemorrhage. Conclusion. Serial fetal imaging following maternal trauma, particularly when accompanied by abnormal fetal heart rate tracings, should be considered when fetal injury is a concern, even in the setting of a normal initial ultrasound.