Neonatal Subclavian Artery Thrombosis at Birth A Case Report

سال انتشار: 1398
نوع سند: مقاله کنفرانسی
زبان: انگلیسی
مشاهده: 353

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شناسه ملی سند علمی:

COBGY15_100

تاریخ نمایه سازی: 11 آبان 1398

چکیده مقاله:

Backgrounds: Vascular thrombosis is rare in neonatal period with prevalence of 0.5 per 10000 live births and has severe morbidity and mortality based on site of thrombosis. The most common cause of neonatal vascular thrombosis is iatrogenic including arterial or venous catheterization. Other risk factors include maternal lupus and diabetes and neonatal sepsis, poor cardiac output and congenital thrombotic disorder. We present a case of neonatal subclavian artery thrombosis which appeared at birth.Material and Method: Case Presentation: A 39-week male neonate was born via cesarean section due to late deceleration and meconium aspiration with apgar score of 8 and umbilical artery pH of 7.00. At birth, right arm was swollen and in examination paralysis was observed and it was painful in movement. Both upper extremities had same temperature and radial artery pulse was weak. Maternal prenatal care was normal without any history of diabetes, hypertension or lupus erythematosus.Result: Color Doppler ultrasonography revealed an obstruction in middle to distal end of subclavian artery and proximal part of axillary artery. Laboratory findings were unremarkable. Unfractionated heparin infusion was started. Two days later swelling progressed and radial pulse disappeared and fingers became cyanotic, but there was no critical sign of ischemia. Neonatal echocardiography revealed no abnormality and no cardiac source for thrombosis. Brain, abdominal and kidney evaluation with sonography showed no thrombosis. Evaluation for hypercoagulability was negative. The infant was admitted in NICU and heparin infusion was continued. After 30 days of treatment swelling and paralysis of arm and cyanosis of fingers gradually improved and disappeared and arm color and movement restored with no residual damage.Conclusion: Thromboembolic events are rare in neonatal period and early diagnosis and treatment can prevent mortality and reduce morbidity. We found a spontaneous subclavian artery thrombosis in a neonate without any risk factor except for a subtle asphyxia

نویسندگان

Mahin Bandarian

MD Ziaeian Hospital, Tehran University of Medical Sciences, Tehran, Iran