ABSTRACT
A 34-year-old Korean woman who had been taking warfarin for 14 years after mitral valve replacement became pregnant. She was heparinized betwen 6 and14 weeks of gestation and was then restarted on oral anticoagulants. At 32 weeks of gestation, fetal ultrasonography revealed overt enlargement of the left lateral ventricles. There was an echogenic mass in the right hemisphere with mild ventricular enlargement. An elective repeat cesarean section was performed. Three days later, the neonate underwent a Burr-hole procedure, from which bloody fluid was drained and the intracranial hemorrhage was confirmed. We must keep in mind the severe adverse fetal outcomes associated with warfarin-induced fetal intracranial hemorrhage during pregnancy. Despite its therapeutic advantages, regular fetal monitoring, ultrasonography, and management of prothrombin time are needed.
Subject(s)
Adult , Female , Humans , Infant, Newborn , Pregnancy , Anticoagulants , Cesarean Section, Repeat , Fetal Monitoring , Heparin , Intracranial Hemorrhages , Lateral Ventricles , Mitral Valve , Prothrombin Time , Ultrasonography, Prenatal , WarfarinABSTRACT
Fetal intracranial hemorrhage is quite rare. Antenatal fetal intracranial hemorrhage may occur spontaneously, or in association with various maternal or fetal conditions. Currently, antenatal fetal intracranial hemorrhage may be diagnosed by imaging techniques including ultrasonography and less frequently, magnetic resonance imaging (MRI). We report a case of spontaneous fetal intracranial hemorrhage that was diagnosed antenatally in the third trimester with a brief review of literatures.