In utero brachial artery thrombosis: limb salvage with postnatal urokinase infusion.

In utero brachial artery thrombosis leading to neonatal extremity gangrene can occur from a variety of causes. Traditional management has been limited to supportive care, often leading to early amputation. We report a case of a 1-day-old neonate who presented with an in utero brachial artery thrombosis and whose treatment consisted of early, aggressive systemic thrombolytic therapy followed by serial soft-tissue debridement and ultimate skin coverage through cultured epithelial autografts. This resulted in a successfully salvaged and partially functional upper extremity.