Introduction:
Upper limb ischemia presenting in the neonatal period is exceedingly rare1. Limb ischemia occurring in utero has three main causes: thrombosis, embolism, and in utero compression2. Neonatal arterial thrombosis and embolism are serious conditions that often result in high morbidity and mortality.3,4 Approximately 90% of neonatal arterial thromboembolic (TE) events are linked to iatragenic causes, including catheterization.4,5 TE events occurring in utero are especially rare, and can lead to congenital Volkmann ischemic contractures (also known as neonatal compartment syndrome). Early recognition and prompt intervention of these events are required to restore perfusion and reduce morbidity.
We present a case of a premature neonate born to a mother with gestation diabetes. The newborn had an in utero atrial thrombosis of unknown etiology with a right arm congenital Volkmann’s contracture, consistent with ischemia but without evidence of gangrene. The newborn was treated with an urgent fasciotomy resulting in immediate return of blood flow to his affected extremity. A brief review of literature was included for discussion.
Methods:
The literature review for this …show more content…
However, it is often described as being related to several intrinsic and extrinsic factors. Intrinsic factors include a hypercoagulable state that results in intra-arterial or intravenous thrombosis. Extrinsic factors include maternal and gestational diabetes, oligohydramnios, multiple gestations, fetal macrosomia, and abnormal intra-utero
Upper limb ischemia presenting in the neonatal period is exceedingly rare1. Limb ischemia occurring in utero has three main causes: thrombosis, embolism, and in utero compression2. Neonatal arterial thrombosis and embolism are serious conditions that often result in high morbidity and mortality.3,4 Approximately 90% of neonatal arterial thromboembolic (TE) events are linked to iatragenic causes, including catheterization.4,5 TE events occurring in utero are especially rare, and can lead to congenital Volkmann ischemic contractures (also known as neonatal compartment syndrome). Early recognition and prompt intervention of these events are required to restore perfusion and reduce morbidity.
We present a case of a premature neonate born to a mother with gestation diabetes. The newborn had an in utero atrial thrombosis of unknown etiology with a right arm congenital Volkmann’s contracture, consistent with ischemia but without evidence of gangrene. The newborn was treated with an urgent fasciotomy resulting in immediate return of blood flow to his affected extremity. A brief review of literature was included for discussion.
Methods:
The literature review for this …show more content…
However, it is often described as being related to several intrinsic and extrinsic factors. Intrinsic factors include a hypercoagulable state that results in intra-arterial or intravenous thrombosis. Extrinsic factors include maternal and gestational diabetes, oligohydramnios, multiple gestations, fetal macrosomia, and abnormal intra-utero