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Neonatal hemoperitoneum: unexpected birth trauma with fatal consequences.
Maria Serenella Pignotti1, Patrizio Fiorini, Gianpaolo Donzelli
1Department of Paediatrics, Neonatal Medicine, Anna Meyer Children's Hospital, University of Florence, Florence, Italy.
Journal of Clinical Neonatology
|November 20, 2013
Summary
A term newborn experienced fatal intra-abdominal bleeding following vacuum extractor and Kristeller maneuver delivery. Evidence suggests massive hemorrhage from hypochondriac organ injuries, likely severing a vascular pedicle.
Area of Science:
- Obstetrics and Gynecology
- Neonatal Medicine
- Pediatric Surgery
Background:
- Delivery interventions like vacuum extraction and Kristeller maneuver are associated with potential neonatal complications.
- Intra-abdominal bleeding is a rare but critical complication in newborns.
Observation:
- A term newborn presented with fatal intra-abdominal bleeding post-delivery.
- Delivery was complicated by the use of vacuum extractor and Kristeller maneuver.
- Autopsy was declined by parents, but clinical evidence pointed towards severe internal hemorrhage.
Findings:
- Massive abdominal hemorrhage was the presumed cause of death.
- Injuries to hypochondriac organs were suspected.
- Disconnection of a vascular pedicle was hypothesized as the mechanism of bleeding.
Implications:
- Highlights the critical need for vigilance regarding potential intra-abdominal injuries in neonates after operative vaginal delivery.
- Underscores the importance of prompt diagnosis and management of neonatal hemorrhage.
- Emphasizes the potential risks associated with vacuum extractor and Kristeller maneuver use.
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