Active Crohn disease with maternal vitamin K deficiency and fetal subdural hematoma.
BACKGROUND
Fetal subdural hematoma is a rare condition not considered a complication of Crohn disease in pregnancy.


METHODS
A young woman with a diagnosis of Crohn disease presented at 22 weeks' gestation with diarrhea and melena for 3 weeks. Dietary and medicinal therapies were begun. At 28 weeks' gestation, fetal ultrasonography showed an intracranial mass, which was seen to expand on serial ultrasound and magnetic resonance imaging studies. A hematoma was suspected, and, although the mother had no overt hemorrhagic manifestations, maternal vitamin K deficiency was diagnosed by enzyme immunoassay and corrected. After cesarean delivery at 36 weeks' gestation, the newborn was normal, but magnetic resonance imaging showed a chronic subdural hematoma.


CONCLUSIONS
Maternal vitamin K deficiency in active Crohn disease might cause fetal hemorrhage. Monitoring of vitamin K status during pregnancy with Crohn disease seems warranted.
Hirose
M
M
Department of Obstetrics and Gynecology, Shiga University of Medical Science, Ohtsu, Japan. hirose@belle.shiga-med.ac.jp
Akiyama
M
M
Takakura
K
K
Noda
Y
Y
D000328:Adult; D003424:Crohn Disease / Q000150:complications*; D005260:Female; D005315:Fetal Diseases / Q000175:diagnosis / Q000209:etiology*; D006408:Hematoma, Subdural / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D011247:Pregnancy; D016216:Ultrasonography, Prenatal; D014813:Vitamin K Deficiency / Q000150:complications*