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Intrauterine injury simulating abusive head trauma
Omar S Faridi1, Lawrence Y Ho, Michael T Trese
1From the *Beaumont Eye Institute, William Beaumont Hospital, Royal Oak, Michigan; and †Associated Retinal Consultants, William Beaumont Hospital, Royal Oak, Michigan.
Purpose:
The purpose of this study was to describe a patient with intrauterine injury simulating abusive head trauma and its management.
Methods:
A case report of a premature infant born at 35 weeks 2 days through an uncomplicated vaginal delivery was found to have cerebral hemorrhages on magnetic resonance imaging after presenting with respiratory distress. The infant was referred to us for bilateral subconjunctival hemorrhages and periorbital edema. We performed serial ophthalmologic examinations, reviewed all prenatal history with the mother of the infant, and reviewed all relevant hospital notes, laboratory results, and imaging results.
Results:
On ophthalmologic examination, the patient was found to have vitreous and retinal hemorrhages bilaterally. Prenatal history showed intrauterine trauma inflicted by the mother in the setting of an atraumatic delivery. The patient required bilateral vitrectomies to prevent amblyopia.
Conclusion:
Intrauterine injury may simulate abusive head trauma, and it is important for clinicians to recognize this presentation to prevent further harm to the infant and prevent devastating visual loss.