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Massive fetomaternal haemorrhage (FMH) occurs in 0.12 to 0.5% of pregnancies. It is most often spontaneous and involves uncomplicated near-term pregnancies. It causes fetal anaemia, with or without fetal distress and hydrops fetalis. To our knowledge only one paper has reported a neurological complication (hemiplegia). We describe one case of FMH (maximal Kleihauer test = 6.5%) at 28 weeks gestation, which was spontaneous, reversible, associated with sinusoidal fetal heart rare (FHR) and hydrops fetalis; and complicated by an intraventricular antenatal haemorrhage at 30 weeks gestation. Echographic abnormalities decreased. The infant was born at 40 weeks gestation. Clinical examination was normal during the first week of life. At the age of 4 1/2 months, examination showed axial hypotonia and moderated dilatation of intracerebral lateral ventricules without any other brain damage. At the age of 24 months, the child had retarded walking and hypotonia. The outcome was spontaneously favourable with disappearance in utero of the intraventricular haemorrhage (HIV), without hydrocephalia or ischaemic lesions. Three cases of similar FMH have been reported but none of them described cerebral complications. Intrauterine intravascular transfusion should be proposed early. No single pathophysiological mechanism of FMH has been universally accepted and there is no aetiological treatment. The risk of recurrence of FMH in later pregnancies requires careful follow-up.

Serial ultrasound imaging of the brain was carried out in 87 preterm infants of 27 to 36 weeks' gestational age while they were in the special care nursery and during their first postnatal year. None had evidence of intracranial disease during the neonatal period and 94% had good neurodevelopmental outcome at 2 years of age. Lateral ventricle area measurements were plotted against independent variables including postnatal age and head circumference at the time of the examination. The measurements increased as age and head circumference increased. During the first six weeks of life the mean (SD) postnatal head circumference growth velocity (rate of growth) was 0.53 (0.13) cm/week and the mean postnatal ventricular area growth velocity was 0.39 (0.19) mm2/week. A reference range for lateral ventricle area values was developed from these serial measurements in infants with documented good short term developmental outcome.