[Multicystic neonatal encephalopathy after a traffic accident with minor maternal injuries].
We report a case of traffic accident at 30 weeks of gestation. The maternal injuries were minor. The fetal heart rate patterns showed tachycardia and decreased modulation. Ultrasound scanning was normal, without abruptio placentae. Ten days after the accident, a cesarean section was done on altered fetal heart rate with a normal infant at birth. This baby died 17 days latter from an ischemic multicystic encephalomalacia. With the view of the literature, we try to explain the pathophysiological mechanism of this severe fetal outcome despite minor maternal injuries. Hypovolemic collapsus, caval syndrome and maternal stress could be the cause of placental hypoperfusion. Abruptio placenta and feto-placental hemorrhage are others explanations. We propose the management for first aid workers and the specialized unit care.
Razafintsalama
T
T
Service de Gynécologie-Obstétrique, CHU de Rennes, Hôtel-Dieu.
Coiffic
J
J
Splete
A
A
Chevrant-Breton
O
O
Pladys
P
P
Poulain
P
P
D000063:Accidents, Traffic; D000328:Adult; D002585:Cesarean Section; D004678:Encephalomalacia / Q000000981:diagnostic imaging / Q000209:etiology*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D016216:Ultrasonography, Prenatal; D014947:Wounds and Injuries / Q000209:etiology*