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Washington University Experience | VASCULAR | Hemorrhage - Neonatal | 23A0 Case 23 History
Case 23 History ---- The patient was a 34 week gestation male infant born to a 33 year old woman. The pregnancy was complicated by fetal polycystic kidney disease, diagnosed by ultrasound at 25 and 5/7 weeks, and oligohydramnios. The mother has had a previous pregnancy complicated by fetal polycystic disease, which was terminated by induction of labor at 22 weeks. She has also delivered a healthy full-term infant by cesarean section, which was induced for failure to progress in the last active phase of labor. The mother has a history of thrombocytosis with platelets over one million. She has had no complications from that and has not required any treatment. She was admitted to labor and delivery on 11/17 for induction of labor. She delivered vaginally on 11/19 and the infant expired in 42 minutes. ---- The weight of the unfixed brain is 280 g (normal: 237 + 53 g). Coronal sections of the cerebral hemispheres show a softened, macerated cut surface with germinal matrix hemorrhages bilaterally. Microscopic sections of the periventricular areas show focal germinal matrix hemorrhages surrounded by frontal lobe astrocytosis and rare calcifications, both intraparenchymal and perivascular. The presence of periventricular calcifications strongly suggest intrauterine hypoxic/ischemic damage.
