Hirose M, Akiyama M, Takakura K, Noda Y
Department of Obstetrics and Gynecology, Shiga University of Medical Science, Ohtsu, Japan.
Obstet Gynecol. 2001 Nov;98(5 Pt 2):919-21. doi: 10.1016/s0029-7844(01)01331-x.
Fetal subdural hematoma is a rare condition not considered a complication of Crohn disease in pregnancy.
A young woman with a diagnosis of Crohn disease presented at 22 weeks' gestation with diarrhea and melena for 3 weeks. Dietary and medicinal therapies were begun. At 28 weeks' gestation, fetal ultrasonography showed an intracranial mass, which was seen to expand on serial ultrasound and magnetic resonance imaging studies. A hematoma was suspected, and, although the mother had no overt hemorrhagic manifestations, maternal vitamin K deficiency was diagnosed by enzyme immunoassay and corrected. After cesarean delivery at 36 weeks' gestation, the newborn was normal, but magnetic resonance imaging showed a chronic subdural hematoma.
Maternal vitamin K deficiency in active Crohn disease might cause fetal hemorrhage. Monitoring of vitamin K status during pregnancy with Crohn disease seems warranted.
胎儿硬膜下血肿是一种罕见病症，并非孕期克罗恩病的并发症。
一名诊断为克罗恩病的年轻女性在妊娠22周时出现腹泻和黑便3周。开始进行饮食和药物治疗。妊娠28周时，胎儿超声检查显示颅内有一肿块，在系列超声和磁共振成像检查中可见其增大。怀疑有血肿，尽管母亲没有明显的出血表现，但通过酶免疫测定诊断为母体维生素K缺乏并予以纠正。妊娠36周行剖宫产术后，新生儿正常，但磁共振成像显示有慢性硬膜下血肿。
活动性克罗恩病患者的母体维生素K缺乏可能导致胎儿出血。对于患有克罗恩病的孕妇，监测维生素K状态似乎是必要的。
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