2022 Volume 58 Issue 1 Pages 142-146
Fetal intracranial hemorrhage is a rare disease, occurring in 0.5-0.9 cases per 1,000 cases. We report a case of fetal intracranial hemorrhage due to maternal vitamin K deficiency. At 28 weeks and 6 days of gestation, a 37 years old woman, 3 gravida 0 para, visited our hospital due to an eating disorder accompanied by worsening of psychiatric symptoms. She had not taken sufficient diet for several weeks. She was hospitalized and peripheral parenteral nutrition was administered. Ultrasonography at 30 weeks 3 days of gestation showed a left intracranial occupying lesion, and fetal MRI revealed intracranial hemorrhage. Fetal demise was confirmed at 30 weeks 4 days of gestation. Considering the worsening of the mother’s mental state, the stillborn baby was delivered by cesarean section under general anesthesia. Although maternal blood tests showed no abnormal coagulation, vitamin K1 and K2 were both ≦ 0.05 ng/mL, indicating vitamin K deficiency, which was presumed to be the cause of fetal intracranial hemorrhage. Even in cases such as this case, where maternal blood tests showed no abnormalities in coagulation capacity, management with fetal bleeding in mind should be considered. In addition, fetal MRI can provide detailed evaluation of fetal intracranial hemorrhage, and can be useful in explaining the condition to the family and in deciding on a policy.
