Maternal total parenteral nutrition and fetal subdural hematoma.
BACKGROUND
Fetal subdural hematoma is rare, and no case resulting from vitamin K deficiency secondary to maternal total parenteral nutrition has been reported.


METHODS
A 28-year-old woman was managed with total parenteral nutrition from 28 weeks' gestation because of continuous vomiting due to esophageal hiatal hernia. A sinusoidal pattern by cardiotocogram was observed at 31 weeks' gestation. Serial sonograms showed a fetal subdural hematoma, and cesarean delivery was performed. Although the maternal hepaplastin test result was normal and the maternal PIVKA-II concentration was only slightly elevated, the neonate was severely anemic and had severe vitamin K deficiency.


CONCLUSIONS
Severe fetal vitamin K deficiency can develop even when the maternal deficiency is mild. When maternal total parenteral nutrition is necessary, supplemental vitamin K should be administered.
Department of Obstetrics and Gynecology, Toyama Medical and Pharmaceutical University, Toyama, Japan.
Masatoshi
M
Sakai
Satoshi
S
Yoneda
Yasushi
Y
Sasaki
Shigeru
S
Saito
D000328:Adult; D005260:Female; D005315:Fetal Diseases / Q000000981:diagnostic imaging* / Q000209:etiology*; D006408:Hematoma, Subdural / Q000000981:diagnostic imaging* / Q000209:etiology*; D006551:Hernia, Hiatal / Q000628:therapy*; D006801:Humans; D010289:Parenteral Nutrition, Total; D011247:Pregnancy; D011248:Pregnancy Complications / Q000628:therapy*; D011263:Pregnancy Trimester, Third; D016216:Ultrasonography, Prenatal; D014813:Vitamin K Deficiency / Q000150:complications*