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Fetal adrenal haemorrhage

Dr Abhilash Sandhyala and Dr Yuranga Weerakkody et al.

A fetal adrenal haemorrhage is an uncommon occurrence.

Pathology

The exact cause of adrenal bleeding in utero is not well known at the time of writing. It may be associated with congenital infections ⁸.

Location

There is greater incidence on the right side.

Radiographic features

Ultrasound

An adrenal haemorrhage may be seen as a mass above the fetal kidneys and will demonstrate changing characteristics in terms of echotexture on sequential images as it evolves from hyper echoic to iso-echoic to hypo-echoic. Colour Doppler interrogation with not show any associated intrinsic vascularity. The haematoma may also change in size through time.

Differential diagnosis

For a fetal adrenal mass consider

fetal neuroblastoma : often has associated vascularity
sub diaphragmatic extra-lobar pulmonary sequestration : may have a predilection towards the left side
fetal adrenal cyst : consideration for hypo-echoic lesions

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References

Synonyms & Alternative Spellings

Synonyms or Alternative Spelling	Include in Listings?
Fetal adrenal hemorrhage	✗
Fetal adrenal bleed	✗
In utero adrenal hemorrhage	✗
In utero adrenal haemorrhage	✗
Fetal adrenal haematoma	✗
Fetal adrenal hematoma	✗