Subcortical bruising in the preterm infant

A cranial ultrasound (CUS) was performed on day 2 of a 27-week, 3-day gestational age newborn, with no external clinical signs or history of trauma during delivery nor concerns of significant thrombocytopenia or coagulopathy, prompted by acute drop in haematocrit (from 17.5 to 11.4 g/dL). Perinatal history was significant for in vitro fertilisation pregnancy, cervical cerclage, pregestational diabetes mellitus, gestational hypertension and premature prolonged membrane rupture, followed by a course of betamethasone and magnesium sulfate, then delivery by stat section for prolapsed cord. Resuscitation was uneventful except for endotracheal intubation lasting 3 hours for surfactant administration, followed by continuous positive airway pressure (CPAP). Initial and subsequent CUS showed several echogenicities grouped in the left subcortical frontoparietal parenchyma (figure 1). Differential diagnoses included heterotopia, calcification or haemorrhage. MRI on day 18 confirmed small areas of parenchymal haemorrhage within left superior frontal subcortical white matter in the T1, T2 and...
Source: Archives of Disease in Childhood - Fetal and Neonatal Edition - Category: Perinatology & Neonatology Authors: Tags: Images in neonatal medicine Source Type: research