• Baorong Gao, Li Zhang, and Qiang Wei.
• Department of Obstetrics and Gynaecology, West China Second University Hospital, Key Laboratory of Birth Defects and Related Diseases of Women and Children of the Ministry of Education, Sichuan University, No.20, Section 3, Renmin Nan Lu, Chengdu, Sichuan Province, China.
• Medicine (Baltimore). 2022 Jun 24; 101 (25): e29335.

RationaleFetal intracranial hemorrhage (ICH) is an extremely rare complication of pregnancy, with subsequent neurological sequelae or fetal death. The diagnosis of fetal ICH is primarily based on ultrasound or magnetic resonance imaging.Patient ConcernsAn asymptomatic woman at 31 weeks of gestation was referred for a detailed anomaly scan because routine fetal ultrasonography showed suspected fetal ICH.DiagnosesFetal ICH with extensive and multifocal hemorrhagic lesions was diagnosed by ultrasound and magnetic resonance imaging imaging and finally confirmed by postmortem examination.InterventionsThe woman opted for pregnancy termination after medical consultation. Labor was induced by mifepristone and rivanol infusion.OutcomesThe patient delivered a stillborn male infant weighing 1522 g. We tried our best to screen the possible etiology contributing to fetal ICH; unfortunately, no evidence of obvious causes or predisposing factors was identified.LessonsMedically unexplained massive fetal ICH may cause an unfavorable prognosis, and prompt termination of pregnancy is appropriate, although there is no consensus on the optimal mode of delivery.Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.

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