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Fetal encephalopathy after maternal anaphylaxis. Case report
R Luciano1, A A Zuppa, G Maragliano
1Department of Pediatrics, Catholic University of the Sacred Heart, Rome, Italy.
Biology of the Neonate
|January 1, 1997
Summary
Maternal anaphylactic shock causing severe hypotension during pregnancy can lead to fetal brain damage, including multicystic encephalomalacia. Diagnosis of this fetal hypoxic-ischemic encephalopathy is possible at birth via cerebral ultrasound.
Area of Science:
- Neurology
- Obstetrics
- Pediatrics
Background:
- Fetal hypoxic-ischemic encephalopathy (HIE) is a significant cause of neonatal brain injury.
- Cerebral ultrasound is a primary diagnostic tool for HIE, with lesion appearance varying by time post-insult.
- Maternal hypotension during pregnancy is a potential, though less common, cause of fetal brain damage.
Observation:
- A case report details a neonate diagnosed with multicystic encephalomalacia and corpus callosum atrophy.
- The fetal brain damage was attributed to maternal anaphylactic shock following intravenous iron injection at 27 weeks gestation.
- Diagnosis was confirmed using cerebral ultrasound at birth and magnetic resonance imaging.
Findings:
- Maternal severe acute hypotension during pregnancy can result in fetal cerebral damage.
- The observed brain lesions mimicked typical hypoxic-ischemic injuries seen in the perinatal period.
- Multicystic encephalomalacia and corpus callosum atrophy were key morphological findings.
Implications:
- This case highlights a rare but severe complication of maternal anaphylaxis during pregnancy.
- It expands the differential diagnosis for fetal brain injury beyond typical perinatal HIE.
- Clinicians should consider maternal hemodynamic instability as a potential etiology for fetal encephalopathy.