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Updated: Nov 2, 2025

Transcutaneous Microcirculatory Imaging in Preterm Neonates
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Multiple thromboses in a late preterm infant present at birth.

Thomas Marriage1, Vrinda Nair2, Thomas Skeath2

  • 1Neonatal Unit, James Cook University Hospital, Middlesbrough, UK thomas.marriage@nhs.net.

BMJ Case Reports
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Summary

A newborn experienced bilateral upper limb arterial thromboses due to maternal diabetes. Early diagnosis and multidisciplinary care led to a successful outcome for this late preterm infant.

Keywords:
dermatologyhaematology (incl blood transfusion)neonatal and paediatric intensive care

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Area of Science:

  • Neonatal Medicine
  • Pediatric Cardiology
  • Vascular Biology

Background:

  • Maternal diabetes mellitus is a known risk factor for adverse perinatal outcomes.
  • Reduced fetal movements and poor cardiotocography (CTG) indicate potential fetal distress.
  • Congenital arterial anomalies can present with significant morbidity.

Observation:

  • A late preterm infant presented with visible upper limb abnormalities at birth.
  • Clinical examination revealed signs suggestive of vascular compromise in both upper limbs.
  • Initial assessment indicated a critical condition requiring urgent investigation.

Findings:

  • Diagnostic workup confirmed bilateral upper limb arterial thromboses.
  • The thromboses were identified as the primary cause of the observed limb pathology.
  • This diagnosis highlighted a rare but severe neonatal vascular complication.

Implications:

  • Prompt diagnosis and intervention are crucial for managing neonatal arterial thromboses.
  • Multidisciplinary collaboration involving neonatologists, pediatric cardiologists, and vascular surgeons is essential.
  • Individualized management plans can lead to positive outcomes in complex neonatal cases.