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<meta name="DC.Title" content="Fetal Intraventricular Hemorrhage in Open Neural Tube Defects: Prenatal Imaging Evaluation and Perinatal Outcomes" />
<meta name="DC.Identifier" content="10.3174/ajnr.A6745" />
<meta name="DC.Date" content="2020-10-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
<meta name="DC.Rights" content="© 2020 by American Journal of Neuroradiology" />
<meta name="DC.AccessRights" content="restricted" />
<meta name="DC.Description" content="BACKGROUND AND PURPOSE: Fetal imaging is crucial in the evaluation of open neural tube defects. The identification of intraventricular hemorrhage prenatally has unclear clinical implications. We aimed to explore fetal imaging findings in open neural tube defects and evaluate associations between intraventricular hemorrhage with prenatal and postnatal hindbrain herniation, postnatal intraventricular hemorrhage, and ventricular shunt placement.

MATERIALS AND METHODS: After institutional review board approval, open neural tube defect cases evaluated by prenatal sonography between January 1, 2013 and April 24, 2018 were enrolled ( n = 504). The presence of intraventricular hemorrhage and gray matter heterotopia by both prenatal sonography and MR imaging studies was used for classification. Cases of intraventricular hemorrhage had intraventricular hemorrhage without gray matter heterotopia ( n = 33) and controls had neither intraventricular hemorrhage nor gray matter heterotopia ( n = 229). A total of 135 subjects with findings of gray matter heterotopia were excluded. Outcomes were compared with regression analyses.

RESULTS: Prenatal and postnatal hindbrain herniation and postnatal intraventricular hemorrhage were more frequent in cases of prenatal intraventricular hemorrhage compared with controls (97% versus 79%, 50% versus 25%, and 63% versus 12%, respectively). Increased third ventricular diameter, specifically &gt;1 mm, predicted hindbrain herniation (OR = 3.7 [95% CI, 1.5–11]) independent of lateral ventricular size and prenatal intraventricular hemorrhage. Fetal closure ( n = 86) was independently protective against postnatal hindbrain herniation (OR = 0.04 [95% CI, 0.01–0.15]) and postnatal intraventricular hemorrhage (OR = 0.2 [95% CI, 0.02–0.98]). Prenatal intraventricular hemorrhage was not associated with ventricular shunt placement.

CONCLUSIONS: Intraventricular hemorrhage is relatively common in the prenatal evaluation of open neural tube defects. Hindbrain herniation is more common in cases of intraventricular hemorrhage, but in association with increased third ventricular size. Fetal closure reverses hindbrain herniation and decreases the rate of intraventricular hemorrhage postnatally, regardless of the presence of prenatal intraventricular hemorrhage.

NTD
:   neural tube defects
BPD
:   biparietal diameter
GA
:   gestational age by sonography
IVH
:   intraventricular hemorrhage
HC
:   head circumference
HH
:   hindbrain herniation
GMH
:   gray matter heterotopia
ONTD
:   open neural tube defects
MMC
:   myelomeningocele
MS
:   myeloschisis
MOMS
:   Management of Myelomeningocele Study
HC/AC
:   head circircumferenceto abdominal circumference ratio" />
<meta name="DC.Contributor" content="R.A. Didier" />
<meta name="DC.Contributor" content="J.S. Martin-Saavedra" />
<meta name="DC.Contributor" content="E.R. Oliver" />
<meta name="DC.Contributor" content="S.E. DeBari" />
<meta name="DC.Contributor" content="L.T. Bilaniuk" />
<meta name="DC.Contributor" content="L.J. Howell" />
<meta name="DC.Contributor" content="J.S. Moldenhauer" />
<meta name="DC.Contributor" content="N.S. Adzick" />
<meta name="DC.Contributor" content="G.G. Heuer" />
<meta name="DC.Contributor" content="B.G. Coleman" />
<meta name="article:published_time" content="2020-10-01" />
<meta name="article:section" content="Pediatrics" />
<meta name="citation_title" content="Fetal Intraventricular Hemorrhage in Open Neural Tube Defects: Prenatal Imaging Evaluation and Perinatal Outcomes" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;Fetal imaging is crucial in the evaluation of open neural tube defects. The identification of intraventricular hemorrhage prenatally has unclear clinical implications. We aimed to explore fetal imaging findings in open neural tube defects and evaluate associations between intraventricular hemorrhage with prenatal and postnatal hindbrain herniation, postnatal intraventricular hemorrhage, and ventricular shunt placement.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;After institutional review board approval, open neural tube defect cases evaluated by prenatal sonography between January 1, 2013 and April 24, 2018 were enrolled (&lt;i&gt;n&lt;/i&gt; = 504). The presence of intraventricular hemorrhage and gray matter heterotopia by both prenatal sonography and MR imaging studies was used for classification. Cases of intraventricular hemorrhage had intraventricular hemorrhage without gray matter heterotopia (&lt;i&gt;n&lt;/i&gt; = 33) and controls had neither intraventricular hemorrhage nor gray matter heterotopia (&lt;i&gt;n&lt;/i&gt; = 229). A total of 135 subjects with findings of gray matter heterotopia were excluded. Outcomes were compared with regression analyses.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;Prenatal and postnatal hindbrain herniation and postnatal intraventricular hemorrhage were more frequent in cases of prenatal intraventricular hemorrhage compared with controls (97% versus 79%, 50% versus 25%, and 63% versus 12%, respectively). Increased third ventricular diameter, specifically &amp;gt;1 mm, predicted hindbrain herniation (OR = 3.7 [95% CI, 1.5–11]) independent of lateral ventricular size and prenatal intraventricular hemorrhage. Fetal closure (&lt;i&gt;n&lt;/i&gt; = 86) was independently protective against postnatal hindbrain herniation (OR = 0.04 [95% CI, 0.01–0.15]) and postnatal intraventricular hemorrhage (OR = 0.2 [95% CI, 0.02–0.98]). Prenatal intraventricular hemorrhage was not associated with ventricular shunt placement.&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;Intraventricular hemorrhage is relatively common in the prenatal evaluation of open neural tube defects. Hindbrain herniation is more common in cases of intraventricular hemorrhage, but in association with increased third ventricular size. Fetal closure reverses hindbrain herniation and decreases the rate of intraventricular hemorrhage postnatally, regardless of the presence of prenatal intraventricular hemorrhage.&lt;/p&gt;" />
<meta name="citation_journal_title" content="American Journal of Neuroradiology" />
<meta name="citation_publisher" content="American Journal of Neuroradiology" />
<meta name="citation_publication_date" content="2020/10/01" />
<meta name="citation_mjid" content="ajnr;41/10/1923" />
<meta name="citation_id" content="41/10/1923" />
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<meta name="citation_issn" content="0195-6108" />
<meta name="citation_issn" content="1936-959X" />
<meta name="citation_doi" content="10.3174/ajnr.A6745" />
<meta name="citation_pmid" content="32943419" />
<meta name="citation_volume" content="41" />
<meta name="citation_issue" content="10" />
<meta name="citation_article_type" content="Research Article" />
<meta name="citation_section" content="Pediatrics" />
<meta name="citation_firstpage" content="1923" />
<meta name="citation_lastpage" content="1929" />
<meta name="citation_author" content="R.A. Didier" />
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<meta name="citation_author" content="J.S. Martin-Saavedra" />
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<meta name="citation_author" content="E.R. Oliver" />
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<meta name="citation_author" content="L.T. Bilaniuk" />
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<meta name="twitter:title" content="Fetal Intraventricular Hemorrhage in Open Neural Tube Defects: Prenatal Imaging Evaluation and Perinatal Outcomes" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Fetal imaging is crucial in the evaluation of open neural tube defects. The identification of intraventricular hemorrhage prenatally has unclear clinical implications. We aimed to explore fetal imaging findings in open neural tube defects and evaluate associations between intraventricular hemorrhage with prenatal and postnatal hindbrain herniation, postnatal intraventricular hemorrhage, and ventricular shunt placement.

MATERIALS AND METHODS: After institutional review board approval, open neural tube defect cases evaluated by prenatal sonography between January 1, 2013 and April 24, 2018 were enrolled ( n = 504). The presence of intraventricular hemorrhage and gray matter heterotopia by both prenatal sonography and MR imaging studies was used for classification. Cases of intraventricular hemorrhage had intraventricular hemorrhage without gray matter heterotopia ( n = 33) and controls had neither intraventricular hemorrhage nor gray matter heterotopia ( n = 229). A total of 135 subjects with findings of gray matter heterotopia were excluded. Outcomes were compared with regression analyses.

RESULTS: Prenatal and postnatal hindbrain herniation and postnatal intraventricular hemorrhage were more frequent in cases of prenatal intraventricular hemorrhage compared with controls (97% versus 79%, 50% versus 25%, and 63% versus 12%, respectively). Increased third ventricular diameter, specifically &gt;1 mm, predicted hindbrain herniation (OR = 3.7 [95% CI, 1.5–11]) independent of lateral ventricular size and prenatal intraventricular hemorrhage. Fetal closure ( n = 86) was independently protective against postnatal hindbrain herniation (OR = 0.04 [95% CI, 0.01–0.15]) and postnatal intraventricular hemorrhage (OR = 0.2 [95% CI, 0.02–0.98]). Prenatal intraventricular hemorrhage was not associated with ventricular shunt placement.

CONCLUSIONS: Intraventricular hemorrhage is relatively common in the prenatal evaluation of open neural tube defects. Hindbrain herniation is more common in cases of intraventricular hemorrhage, but in association with increased third ventricular size. Fetal closure reverses hindbrain herniation and decreases the rate of intraventricular hemorrhage postnatally, regardless of the presence of prenatal intraventricular hemorrhage.

NTD
:   neural tube defects
BPD
:   biparietal diameter
GA
:   gestational age by sonography
IVH
:   intraventricular hemorrhage
HC
:   head circumference
HH
:   hindbrain herniation
GMH
:   gray matter heterotopia
ONTD
:   open neural tube defects
MMC
:   myelomeningocele
MS
:   myeloschisis
MOMS
:   Management of Myelomeningocele Study
HC/AC
:   head circircumferenceto abdominal circumference ratio" />
<meta name="og-title" property="og:title" content="Fetal Intraventricular Hemorrhage in Open Neural Tube Defects: Prenatal Imaging Evaluation and Perinatal Outcomes" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/41/10/1923" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: Fetal imaging is crucial in the evaluation of open neural tube defects. The identification of intraventricular hemorrhage prenatally has unclear clinical implications. We aimed to explore fetal imaging findings in open neural tube defects and evaluate associations between intraventricular hemorrhage with prenatal and postnatal hindbrain herniation, postnatal intraventricular hemorrhage, and ventricular shunt placement.

MATERIALS AND METHODS: After institutional review board approval, open neural tube defect cases evaluated by prenatal sonography between January 1, 2013 and April 24, 2018 were enrolled ( n = 504). The presence of intraventricular hemorrhage and gray matter heterotopia by both prenatal sonography and MR imaging studies was used for classification. Cases of intraventricular hemorrhage had intraventricular hemorrhage without gray matter heterotopia ( n = 33) and controls had neither intraventricular hemorrhage nor gray matter heterotopia ( n = 229). A total of 135 subjects with findings of gray matter heterotopia were excluded. Outcomes were compared with regression analyses.

RESULTS: Prenatal and postnatal hindbrain herniation and postnatal intraventricular hemorrhage were more frequent in cases of prenatal intraventricular hemorrhage compared with controls (97% versus 79%, 50% versus 25%, and 63% versus 12%, respectively). Increased third ventricular diameter, specifically &gt;1 mm, predicted hindbrain herniation (OR = 3.7 [95% CI, 1.5–11]) independent of lateral ventricular size and prenatal intraventricular hemorrhage. Fetal closure ( n = 86) was independently protective against postnatal hindbrain herniation (OR = 0.04 [95% CI, 0.01–0.15]) and postnatal intraventricular hemorrhage (OR = 0.2 [95% CI, 0.02–0.98]). Prenatal intraventricular hemorrhage was not associated with ventricular shunt placement.

CONCLUSIONS: Intraventricular hemorrhage is relatively common in the prenatal evaluation of open neural tube defects. Hindbrain herniation is more common in cases of intraventricular hemorrhage, but in association with increased third ventricular size. Fetal closure reverses hindbrain herniation and decreases the rate of intraventricular hemorrhage postnatally, regardless of the presence of prenatal intraventricular hemorrhage.

NTD
:   neural tube defects
BPD
:   biparietal diameter
GA
:   gestational age by sonography
IVH
:   intraventricular hemorrhage
HC
:   head circumference
HH
:   hindbrain herniation
GMH
:   gray matter heterotopia
ONTD
:   open neural tube defects
MMC
:   myelomeningocele
MS
:   myeloschisis
MOMS
:   Management of Myelomeningocele Study
HC/AC
:   head circircumferenceto abdominal circumference ratio" />
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    <div class="highwire-article-citation highwire-citation-type-highwire-article node78833--5" data-node-nid="78833" id="top-node-78833--61157182036" data-pisa="ajnr;41/10/1923" data-pisa-master="ajnr;ajnr.A6745" data-apath="/ajnr/41/10/1923.atom" data-hw-author-tooltip-instance="highwire_author_tooltip"><div class="highwire-cite highwire-cite-highwire-article highwire-citation-jcore-article-title-complete clearfix has-author-tooltip highwire-citation-highwire-article-top-a">
  
  
      <div class="highwire-cite-overline"><span  class="highwire-cite-metadata-article-type highwire-cite-metadata">Research Article</span><span class="separator-pipe"></span><span  class="highwire-cite-metadata-art-cat highwire-cite-metadata"><span class="wrapper">Pediatrics</span></span></div>
  
      <div class="highwire-cite-access"><span class="highwire-citation-access highwire-citation-access-check" data-pisa-id="ajnr;ajnr.A6745" data-atom-uri="/ajnr/41/10/1923.atom" data-request-view="full"></span></div>
  
      <h1 class="highwire-cite-title" id="page-title">Fetal Intraventricular Hemorrhage in Open Neural Tube Defects: Prenatal Imaging Evaluation and Perinatal Outcomes</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">R.A. Didier</span>, <span class="highwire-citation-author" data-delta="1">J.S. Martin-Saavedra</span>, <span class="highwire-citation-author" data-delta="2">E.R. Oliver</span>, <span class="highwire-citation-author" data-delta="3">S.E. DeBari</span>, <span class="highwire-citation-author" data-delta="4">L.T. Bilaniuk</span>, <span class="highwire-citation-author" data-delta="5">L.J. Howell</span>, <span class="highwire-citation-author" data-delta="6">J.S. Moldenhauer</span>, <span class="highwire-citation-author" data-delta="7">N.S. Adzick</span>, <span class="highwire-citation-author" data-delta="8">G.G. Heuer</span> and <span class="highwire-citation-author" data-delta="9">B.G. Coleman</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">October 2020,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">41 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(10) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1923-1929; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A6745 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-78833--61157182036" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">R.A. Didier </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>Department of Radiology (R.A.D., J.S.M-S., E.R.O., S.E.D., L.T.B., B.G.C.), The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania</div><div class='author-affiliation'><span class='nlm-sup'>b</span>Center for Fetal Diagnosis and Treatment (R.A.D., E.R.O., S.E.D., L.T.B., L.J.H., J.S.M., N.S.A., G.G.H., B.G.C.), The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania</div><div class='author-affiliation'><span class='nlm-sup'>c</span>Perelman School of Medicine (R.A.D., E.R.O., L.T.B., J.S.M., N.S.A., G.G.H., B.G.C.), University of Pennsylvania, Philadelphia, Pennsylvania</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=R.A.%2BDidier%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Didier%20R&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AR.A.%2BDidier%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-4970-9905" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for R.A. Didier</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">J.S. Martin-Saavedra </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>Department of Radiology (R.A.D., J.S.M-S., E.R.O., S.E.D., L.T.B., B.G.C.), The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=J.S.%2BMartin-Saavedra%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Martin-Saavedra%20J&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AJ.S.%2BMartin-Saavedra%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-4197-5424" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for J.S. Martin-Saavedra</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">E.R. Oliver </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>Department of Radiology (R.A.D., J.S.M-S., E.R.O., S.E.D., L.T.B., B.G.C.), The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania</div><div class='author-affiliation'><span class='nlm-sup'>b</span>Center for Fetal Diagnosis and Treatment (R.A.D., E.R.O., S.E.D., L.T.B., L.J.H., J.S.M., N.S.A., G.G.H., B.G.C.), The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania</div><div class='author-affiliation'><span class='nlm-sup'>c</span>Perelman School of Medicine (R.A.D., E.R.O., L.T.B., J.S.M., N.S.A., G.G.H., B.G.C.), University of Pennsylvania, Philadelphia, Pennsylvania</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=E.R.%2BOliver%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Oliver%20E&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AE.R.%2BOliver%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-5821-5085" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for E.R. Oliver</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">S.E. DeBari </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>Department of Radiology (R.A.D., J.S.M-S., E.R.O., S.E.D., L.T.B., B.G.C.), The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania</div><div class='author-affiliation'><span class='nlm-sup'>b</span>Center for Fetal Diagnosis and Treatment (R.A.D., E.R.O., S.E.D., L.T.B., L.J.H., J.S.M., N.S.A., G.G.H., B.G.C.), The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=S.E.%2BDeBari%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=DeBari%20S&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AS.E.%2BDeBari%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-4781-4365" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for S.E. DeBari</a></li></ul></div><div class="author-tooltip-4"><div class="author-tooltip-name">L.T. Bilaniuk </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>Department of Radiology (R.A.D., J.S.M-S., E.R.O., S.E.D., L.T.B., B.G.C.), The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania</div><div class='author-affiliation'><span class='nlm-sup'>b</span>Center for Fetal Diagnosis and Treatment (R.A.D., E.R.O., S.E.D., L.T.B., L.J.H., J.S.M., N.S.A., G.G.H., B.G.C.), The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania</div><div class='author-affiliation'><span class='nlm-sup'>c</span>Perelman School of Medicine (R.A.D., E.R.O., L.T.B., J.S.M., N.S.A., G.G.H., B.G.C.), University of Pennsylvania, Philadelphia, Pennsylvania</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=L.T.%2BBilaniuk%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Bilaniuk%20L&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AL.T.%2BBilaniuk%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-3817-1142" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for L.T. Bilaniuk</a></li></ul></div><div class="author-tooltip-5"><div class="author-tooltip-name">L.J. Howell </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Center for Fetal Diagnosis and Treatment (R.A.D., E.R.O., S.E.D., L.T.B., L.J.H., J.S.M., N.S.A., G.G.H., B.G.C.), The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania</div><div class='author-affiliation'><span class='nlm-sup'>d</span>Department of Surgery (L.J.H., J.S.M., N.S.A., G.G.H.), The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=L.J.%2BHowell%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Howell%20L&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AL.J.%2BHowell%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0003-4112-9292" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for L.J. Howell</a></li></ul></div><div class="author-tooltip-6"><div class="author-tooltip-name">J.S. Moldenhauer </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Center for Fetal Diagnosis and Treatment (R.A.D., E.R.O., S.E.D., L.T.B., L.J.H., J.S.M., N.S.A., G.G.H., B.G.C.), The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania</div><div class='author-affiliation'><span class='nlm-sup'>c</span>Perelman School of Medicine (R.A.D., E.R.O., L.T.B., J.S.M., N.S.A., G.G.H., B.G.C.), University of Pennsylvania, Philadelphia, Pennsylvania</div><div class='author-affiliation'><span class='nlm-sup'>d</span>Department of Surgery (L.J.H., J.S.M., N.S.A., G.G.H.), The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=J.S.%2BMoldenhauer%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Moldenhauer%20J&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AJ.S.%2BMoldenhauer%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0001-7509-5102" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for J.S. Moldenhauer</a></li></ul></div><div class="author-tooltip-7"><div class="author-tooltip-name">N.S. Adzick </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Center for Fetal Diagnosis and Treatment (R.A.D., E.R.O., S.E.D., L.T.B., L.J.H., J.S.M., N.S.A., G.G.H., B.G.C.), The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania</div><div class='author-affiliation'><span class='nlm-sup'>c</span>Perelman School of Medicine (R.A.D., E.R.O., L.T.B., J.S.M., N.S.A., G.G.H., B.G.C.), University of Pennsylvania, Philadelphia, Pennsylvania</div><div class='author-affiliation'><span class='nlm-sup'>d</span>Department of Surgery (L.J.H., J.S.M., N.S.A., G.G.H.), The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=N.S.%2BAdzick%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Adzick%20N&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AN.S.%2BAdzick%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0003-2132-8606" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for N.S. Adzick</a></li></ul></div><div class="author-tooltip-8"><div class="author-tooltip-name">G.G. Heuer </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Center for Fetal Diagnosis and Treatment (R.A.D., E.R.O., S.E.D., L.T.B., L.J.H., J.S.M., N.S.A., G.G.H., B.G.C.), The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania</div><div class='author-affiliation'><span class='nlm-sup'>c</span>Perelman School of Medicine (R.A.D., E.R.O., L.T.B., J.S.M., N.S.A., G.G.H., B.G.C.), University of Pennsylvania, Philadelphia, Pennsylvania</div><div class='author-affiliation'><span class='nlm-sup'>d</span>Department of Surgery (L.J.H., J.S.M., N.S.A., G.G.H.), The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=G.G.%2BHeuer%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Heuer%20G&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AG.G.%2BHeuer%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-1989-0141" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for G.G. Heuer</a></li></ul></div><div class="author-tooltip-9"><div class="author-tooltip-name">B.G. Coleman </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>Department of Radiology (R.A.D., J.S.M-S., E.R.O., S.E.D., L.T.B., B.G.C.), The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania</div><div class='author-affiliation'><span class='nlm-sup'>b</span>Center for Fetal Diagnosis and Treatment (R.A.D., E.R.O., S.E.D., L.T.B., L.J.H., J.S.M., N.S.A., G.G.H., B.G.C.), The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania</div><div class='author-affiliation'><span class='nlm-sup'>c</span>Perelman School of Medicine (R.A.D., E.R.O., L.T.B., J.S.M., N.S.A., G.G.H., B.G.C.), University of Pennsylvania, Philadelphia, Pennsylvania</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=B.G.%2BColeman%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Coleman%20B&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AB.G.%2BColeman%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-1600-4626" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for B.G. 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    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Oct 2020, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">41 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(10) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1923-1929; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A6745 </span></div>
  
  
  
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      <div class="highwire-cite-title">Fetal Intraventricular Hemorrhage in Open Neural Tube Defects: Prenatal Imaging Evaluation and Perinatal Outcomes</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">R.A.</span> <span class="nlm-surname">Didier</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">J.S.</span> <span class="nlm-surname">Martin-Saavedra</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">E.R.</span> <span class="nlm-surname">Oliver</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">S.E.</span> <span class="nlm-surname">DeBari</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">L.T.</span> <span class="nlm-surname">Bilaniuk</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">L.J.</span> <span class="nlm-surname">Howell</span></span>, <span class="highwire-citation-author" data-delta="6"><span class="nlm-given-names">J.S.</span> <span class="nlm-surname">Moldenhauer</span></span>, <span class="highwire-citation-author" data-delta="7"><span class="nlm-given-names">N.S.</span> <span class="nlm-surname">Adzick</span></span>, <span class="highwire-citation-author" data-delta="8"><span class="nlm-given-names">G.G.</span> <span class="nlm-surname">Heuer</span></span>, <span class="highwire-citation-author" data-delta="9"><span class="nlm-given-names">B.G.</span> <span class="nlm-surname">Coleman</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Oct 2020, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">41 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(10) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1923-1929; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A6745 </span></div>
  
  
  
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