Background: Fetal MR neuroimaging (MRI) is increasingly being used to improve diagnosis, ascertain prognosis and help multidisciplinary counselling of parents. However the indications, timing of scans and its benefit in predicting long term outcomes need further clarification.

Aim: To assess outcomes following fetal brain MRI in a tertiary neonatal unit.

Methods: Retrospective review of all patients who had fetal MRI at our unit from August 2010 to November 2013. Fetal MRI was done without sedation on GE Signa 1.5T machine using T2 weighted single shot sequence to acquire images in coronal, sagittal and transverse planes. Postnatally babies had MR imaging on 1.5 or 3T machine & brain ultrasound on GE Logiq P6 machine. Outcomes were reviewed as per ACR-SPR practice Guidleines criteria using a standard proforma devised in collaboration with fetal medicine team.

Results: 40 fetuses had MRI following abnormal antenatal ultrasound scan (35) or due to family history (5). The main indications were ventriculomegaly or malformations. 36 babies had brain USS postnatally. 16 babies had normal postnatal USS.

Postnatal MRI in 11 babies confirmed antenatal diagnosis of agenesis of corpus callosum, hydrocephalous and arachnoid cyst in 9 but was normal in 2 babies.

Out of 38 babies, 3 died, 35 survived to discharge & 2 are still not born. Of 35 survivors, 20 babies were normal at follow up, 7 had neurodisability and 6 did not have follow up. All 7 babies with neurodisability had abnormal postnatal MRI (2 had VP shunt, 1 epilepsy, 1 speech delay, 2 global delay, 1 cerebral palsy).

Foetal MRI directly influenced care in 20% of the study population.

Conclusion: Fetal MR neuroimaging correlates well with postnatal imaging, helps to predict the prognosis and helps guide the clinical care.