Intrauterine Extremity Gangrene and Cerebral Infarction at Term: A Case Report

Tanvig, Mette; Jørgensen, Jan Stener; Nybo, Mads; Zachariassen, Gitte

doi:10.1155/2011/363517

Cited by 11 publications

(15 citation statements)

References 27 publications

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“…Neonatal thrombosis is often caused by catheterization of the umbilical artery or less commonly seen as complication of sepsis or coagulation disorders [1][2][3]. The most common reported risk factors of intrauterine thrombosis include; maternal diabetes, pre-eclampsia, sepsis, polycythemia, fetal compression, uterine anomalies, amniotic bands, oligohydramnios, malpresentation of the fetus with limb prolapse and umbilical cord entanglement [5][6][7].…”

Section: Discussionmentioning

confidence: 99%

“…The infant in present study was administered low molecular weight heparin till discharge after one month. The infant was also given fresh frozen plasma to improve tissue perfusion and supply any deficient factor as it was recommended in few studies [1][2][3][10][11][12][13][14].…”

Section: Discussionmentioning

confidence: 99%

“…Thrombotic events in utero that involve limbs and brain are rare clinical problems with a heterogeneous etiology [1]. Majority of the cases occur due to embolization from the aorta, inferior vena cava, or renal vein to upper extremities and brain [1][2][3].…”

Section: Introductionmentioning

confidence: 99%

“…Majority of the cases occur due to embolization from the aorta, inferior vena cava, or renal vein to upper extremities and brain [1][2][3]. In majority of the cases, no identifiable cause was implicated; although, maternal diabetes was found in about 25% of the cases [2][3][4].…”

Section: Introductionmentioning

confidence: 99%

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Intrauterine Bilateral Upper Limb Gangrene and Cerebral Infarction in Preterm Infant: A Case Report and Literature Review

Alzahrani¹

2017

Pediatr Ther

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Intrauterine limb gangrene with cerebral infarction is a rare condition and only few cases of this condition have been reported. The neonatal thrombosis needs to be distinguished from intrauterine arterial thrombosis as it is caused by catheterization of the umbilical artery or less commonly seen as complication of sepsis or coagulation disorders. The report describes the case of preterm infant with bilateral brachial artery thrombosis in utero and neonatal gangrene of the left forearm. The right forearm of the infant had a small patch of gangrene with irregular areas of edema and bluish discoloration, extending to the hand. The hand of infant was associated with thrombosis of left middle cerebral artery and acute infarction in left cerebral hemisphere. Both of the upper limbs in the patient were affected, including the left cerebral hemisphere; although in majority of the cases, the limbs are equally affected and the left side of the brain is preferentially involved. LMWH was administered in the present case, which significantly improved the upper right limb. Laboratory findings, including the coagulation markers within normal reference, ranges for the chronologic and gestational age. Further complications were prevented by early post-natal use of anticoagulants and prevention of infection; although the exact cause of this condition was not clear.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Intrauterine Bilateral Upper Limb Gangrene and Cerebral Infarction in Preterm Infant: A Case Report and Literature Review

Alzahrani¹

2017

Pediatr Ther

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“…Lower extremity gangrene is even rarer 1. We present a case of lower extremity gangrene in combination with Tetralogy of Fallot (TOF) and postaxial polydactyly of the hand.…”

Section: Descriptionmentioning

confidence: 98%

Intrauterine lower extremity gangrene in a newborn with Tetralogy of Fallot

et al. 2016

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DESCRIPTIONIntrauterine gangrene of an extremity is a rare problem. Lower extremity gangrene is even rarer. 1 We present a case of lower extremity gangrene in combination with Tetralogy of Fallot (TOF) and postaxial polydactyly of the hand. A live male infant was delivered by caesarean section. Delivery occurred at the 34th week of gestation due to meconium aspiration and intrauterine growth retardation. The mother was 35 years of age and had three healthy children. She had been diagnosed with gestational hypertension during this pregnancy. The newborn patient weighed 1740 g (10th centile) and his length was 43 cm (25th centile). After birth, he developed respiratory distress and was intubated. Examination revealed postaxial polydactyly with palpable phalanxes on the left hand, with an attached necrotic soft tissue mass (figure 1), as well as lower extremity gangrene with a visible demarcation line on the left middle thigh (figures 2 and 3).Blood test results were normal except for a low platelet count of 73 000/mm 3 (normal range 130 000-510 000/mm 3 ), elevated D-dimer of 1154.88 ng/mL (normal range <500 ng/mL), low antithrombin III activity of 55% (normal range 70-125%) and low protein-S activity of 22% (normal range 33-93%).Doppler ultrasonography revealed blocked arterial flow below the level of the tibioperoneal trunk. The main, deep and superficial femoral and popliteal arteries were patent. The patient also had TOF, which was diagnosed by a cardiologist. A transfemoral amputation and polydactyly excision were performed on the third day after birth. The histopathological investigation of the tissue blocks from the amputation material was not helpful in identifying the aetiology. On the 32nd day after birth, the patient was operated for TOF. He died on the seventh postoperative day due to cardiac arrest.

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