Fetal dural sinus thrombosis: A systematic review

Prenat Diagn. 2021 Jan;41(2):248-257. doi: 10.1002/pd.5869. Epub 2020 Dec 15.

Abstract

Introduction: Fetal dural sinus thrombosis (DST) is a rare condition. Although numerous case reports exist, the findings appear heterogenous and providing accurate patient counselling remains challenging.

Methods: A systematic literature review was conducted in accordance with PRISMA guidance.

Results: Thirty-one studies including 78 patients were included in this review. No association with maternal or neonatal coagulopathy, infection or trauma was found. The average gestational age at diagnosis was 25 weeks (range 17-34 weeks). Approximately half of foetuses affected were female (48.7%); one quarter were male (25.6%) and one quarter had no sex stated (25.6%). Termination of pregnancy was chosen in 25.6% of cases (20/78). In continuing pregnancies,10.3% (6/58) experienced a perinatal death. Antenatally, the majority of lesions either decreased in size (38.5%) or completely resolved (32.7%). The neonatal or childhood outcome was normal in 88.0% of survivors (44/50). The average age at follow up was 16.4 months, ranging from birth to 6 years.

Conclusion: This review found that 10% of DST cases experience in-utero or neonatal death. In survivors, the majority of cases reduce in size or completely resolve in pregnancy and 85% are reported to have a good outcome. However, further evidence is needed regarding long-term neurocognitive sequelae.

Publication types

  • Systematic Review

MeSH terms

  • Abortion, Induced*
  • Adult
  • Female
  • Fetal Diseases / diagnostic imaging*
  • Fetal Diseases / physiopathology
  • Gestational Age
  • Humans
  • Infant, Newborn
  • Perinatal Death*
  • Pregnancy
  • Pregnancy Outcome
  • Pregnancy Trimester, Second
  • Pregnancy Trimester, Third
  • Sinus Thrombosis, Intracranial / diagnostic imaging*
  • Sinus Thrombosis, Intracranial / physiopathology