Peripheral gangrene in a newborn infant associated with renal and adrenal vein thrombosis

Valderrama, Elsa; Gribetz, Irwin; Strauss, Lotte

doi:10.1016/s0022-3476(72)80462-1

Cited by 25 publications

(14 citation statements)

References 7 publications

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“…26 Infection among newborns of diabetic women has been a problem in the past and, as shown by three of our infants who had severe septicemias (two due to Escherichia coli and one due to staphylococcal infection), this problem still has to be reckoned with. Polycythemia, hyperviscosity, and an increased tendency to thrombosis 27 ' 29 have been features associated with infants of diabetic mothers, but only three infants in this study had a hematocrit (greater than 65 per cent) high enough to require dilution exchange. Others have reported that while respiratory problems and polycythemia may be factors leading to cardiac failure in infants of diabetic mothers, obstructive or nonobstructive cardiomyopathy can also be responsible.…”

Section: Fig 1 Incidence Of Individual Neonatal Problems In Relatiomentioning

confidence: 62%

Neonatal Morbidity Among Infants of Diabetic Mothers

Soler

Malins

1978

Diabetes Care

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While the modern approach to management of diabetic pregnancy has reduced the perinatal mortality significantly, the neonatal morbidity remains high. This study has investigated factors which may account for the persisting high neonatal morbidity when birth trauma has been virtually eliminated and the incidence of respiratory distress syndrome (RDS) considerably reduced. Major congenital malformations emerge not only as the leading cause of perinatal losses but also as an important cause of morbidity. Delivery before 37 weeks increased the incidence of RDS and hypocalcemia, and it is suggested that, when strict metabolic control is used and with the help of facilities to monitor the fetus closely in the last weeks of pregnancy, the number of infants delivered at this early date can be further reduced. The present study also indicates that normoglycemia should also be encouraged on the day of delivery as maternal hyperglycemia at this stage increases the incidence of neonatal hypoglycemia. Jaundice, which very commonly affects newborn infants of diabetic mothers, is influenced by the use of oxytocin for vaginal delivery and by infant overweight (greater than 90th percentile) at birth, factors which are not beyond control. Finally, route of delivery per se may not be important in relation to neonatal morbidity.

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Section: Fig 1 Incidence Of Individual Neonatal Problems In Relatiomentioning

confidence: 62%

Neonatal Morbidity Among Infants of Diabetic Mothers

Soler

Malins

1978

Diabetes Care

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“…Poorly controlled diabetes during pregnancy was an association in seven (15%) cases [6,21,23,42,43,45,46] and in two of these both renal and adrenal venous thromboses were present at necropsy [42,45]. It was previously shown that venous thrombosis, particularly renal and adrenal, occurred in almost 16% of stillbirths born to diabetic mothers compared with less than 1% in nondiabetic mothers [29].…”

Section: Maternal Diabetesmentioning

confidence: 92%

Peripheral ischaemia and gangrene presenting at birth

et al. 1992

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The aetiology of non-iatrogenic causes of peripheral ischaemia and gangrene presenting either at birth or within a few hours of delivery is unknown in the majority of 56 confirmed cases. In this review of 47 cases occurring since 1941 the aetiology was clear in only 6, four due to compression by the encircling umbilical cord. There was no clear association with gestational age, birth weight, maternal age or type of delivery. Seven were infants of poorly controlled diabetic mothers and these may constitute a subgroup due to altered haemostatic mechanisms. Pregnancy hypertension was an association in 7 cases, oligohydramnios in 6. There is only limited support for birth trauma, sepsis, and thrombo-emboli from the ductus arteriosus as causes. There is indirect evidence that thrombo-emboli can migrate from the placental bed to the fetus. In recent years death from this condition has been rare with surgical thrombectomy increasingly successful in late presenting cases. When gangrene is established at birth surgical amputation, autoamputation, or some loss of function is usual. Peripheral ischaemic insults presenting at birth may be part of a wider spectrum of disorders, both prenatal and perinatal, attributable to occlusive vascular disruption.

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“…As with our patient, two of the nine children with congenital thromboses of an extremity had evidence of thrombi elsewhere in the body. The infant reported by Valdenama et al [5] The association between a compound presentation and congenital ischemic necrosis of an extremity is very rare, with only two previously described cases in the medical literature. These infants delivered spontaneously at [8] or near [3] term with a hand presenting between the fetal head and maternal sacrum.…”

Section: Discussionmentioning

confidence: 98%

Congenital Ischemic Forearm Necrosis Associated with a Compound Presentation

Tabes

Mehla

Calhoun

et al. 1999

J Matern Fetal Neonatal Med

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Abshact:An infant born in a compound presentation had ischemic forearm necrosis requiring amputation.Bilateral renal vein thrombosis predating labor and delivery was also diagnosed. The possibility of congenital ischemic necrosis in an extremity should not affect the obstetrical management of compound presentation, but if this complication occurs a search for an underlying coagulopathy is important. J. Matern.-Fetal Med. 1999;8:231-233. o 1999 WiIey-Liss, inc.

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Peripheral gangrene in a newborn infant associated with renal and adrenal vein thrombosis

Cited by 25 publications

References 7 publications

Neonatal Morbidity Among Infants of Diabetic Mothers

Neonatal Morbidity Among Infants of Diabetic Mothers

Peripheral ischaemia and gangrene presenting at birth

Congenital Ischemic Forearm Necrosis Associated with a Compound Presentation

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