Intrauterine intraventricular hemorrhage occurring about 2 weeks or more prior to birth was the cause of congenital hydrocephalus in 4 newborn infants reported from the Abteilung Neonatologie, Universitats-Kinderklinik, Rumelin-strasse 23; D-7400 Tubingen, FR Germany. Multiple pregnancy was an associated risk factor in 2 cases and a hemorrhagic diathesis was present or suspected in 2. Intrauterine diagnosis of subependynal/intraventricular hemorrhage may be made by sonography of the fetal brain when indicated, especially in multiple pregnancy, hemorrhagic diathesis by history, fetal growth retardation, and signs of distress. Postnatally, cerebral ultrasound, CT and examination of the CSF for siderophages may be confirmatory. 
COMMENT. Congenital hydrocephalus occurs in 0.5-1.8/1000 births. Suba-rachnoid hemorrhage at the time of birth has long been invoked as a cause of hydrocephalus (Paine RS. In Pediatric Neurology, Ed. Millichap JG, Ped Clin N Amer 1967;14:779), but the intrauterine development of posthemorrhagic hydrocephalus has been reported only recently. The authors encountered their 4 cases in a period of 2 years so that the incidence may be higher than the literature suggests.