Fetal Subdural Hematoma –? Aspirin induced or Idiopathic – A case report

Background Fetal intracranial haemorrhage (ICH) is a rare antenatal complication that increases perinatal morbidity and mortality and may cause neurodevelopmental delay in surviving babies. Even though the majority of cases are idiopathic, there are many maternal and fetal factors predisposing to ICH. Low dose aspirin has a proven efficacy in secondary preeclampsia, however, with a daily dosage of > 100mg, its safety is not well established and sporadic cases of fetal hemorrhagic complications have been reported. As fetal ICH has prognostic implications for the current and potentially for future pregnancies, in utero diagnosis is of utmost importance. Case Presentation A 34- year- old primigravida was diagnosed with fetal subdural hematoma (SDH) on her routine third trimester ultrasound (USG). There were no predisposing factors except that the patient was on low dose aspirin from 12 ^th week of gestation. On serial USG, the SDH reduced in size. She delivered a healthy baby who was followed till 6 months of age and showed normal neurodevelopment. Conclusions As the number of reported cases of fetal ICH are limited with even rarer SDH, meaningful etiological and prognostic criteria cannot be inferred and parental counseling is challenging.