Maternal total parenteral nutrition and fetal subdural hematoma.

Full Abstract

BACKGROUND: Fetal subdural hematoma is rare, and no case resulting from vitamin K deficiency secondary to maternal total parenteral nutrition has been reported. CASE: A 28-year-old woman was managed with total parenteral nutrition from 28 weeks' gestation because of continuous vomiting due to esophageal hiatal hernia. A sinusoidal pattern by cardiotocogram was observed at 31 weeks' gestation. Serial sonograms showed a fetal subdural hematoma, and cesarean delivery was performed. Although the maternal hepaplastin test result was normal and the maternal PIVKA-II concentration was only slightly elevated, the neonate was severely anemic and had severe vitamin K deficiency. CONCLUSION: Severe fetal vitamin K deficiency can develop even when the maternal deficiency is mild. When maternal total parenteral nutrition is necessary, supplemental vitamin K should be administered.

Author information

Author/s: Sakai, Masatoshi (M); Yoneda, Satoshi (S); Sasaki, Yasushi (Y); Saito, Shigeru (S);

Affiliation: Department of Obstetrics and Gynecology, Toyama Medical and Pharmaceutical University, Toyama, Japan.

Journal and publication information

Publication Type: Case Reports; Journal Article

Journal: Obstetrics and gynecology (Obstet Gynecol), published in United States. (Language: eng)

Reference: 2003-May; vol 101 (issue 5 Pt 2) : pp 1142-4

Dates: Created 2003/05/09; Completed 2003/05/15; Revised 2009/10/26;

PMID: 12738131, status: MEDLINE (last retrieval date: 10/26/2009, IMS Date: )

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