Abstract：
BACKGROUND: Fetal brain hemorrhage is rare. It is caused mainly by maternal trauma or fetal coagulation disorder, but in some cases, vitamin K deficiency may be the cause.
METHODS: We describe the case of a pregnant woman with bowel obstruction who was susceptible to vitamin K deficiency due to oral diet restriction, decreased intestinal absorption, and limited intravenous vitamin K supplementation.
METHODS: After 18 days of intermittent total parenteral nutrition, acute onset of severe fetal brain hemorrhage developed.
METHODS: After acute onset of fetal brain hemorrhage, the patient underwent an emergency cesarean section at 25 + 3 weeks of gestation due to fetal non-reassuring fetal monitoring.
RESULTS: The Apgar score at birth was 0/0, and despite cardiopulmonary resuscitation, neonatal death was confirmed. After the baby was delivered, we checked the maternal upper abdominal cavity and found a massive adhesion in the small bowel to the abdominal wall near the liver and stomach with an adhesion band. The adhesion band, presumably a complication of previous hepatobiliary surgery, appeared to have caused small bowel obstruction. Adhesiolysis between the small bowel and abdominal wall was performed.
CONCLUSIONS: This case demonstrates that even relatively short-term total parenteral nutrition can cause severe fetal brain hemorrhage. Vitamin K supplementation is required for mothers who are expected to be vitamin K deficient, especially if they are on total parenteral nutrition for more than 3 weeks.
METHODS: We describe the case of a pregnant woman with bowel obstruction who was susceptible to vitamin K deficiency due to oral diet restriction, decreased intestinal absorption, and limited intravenous vitamin K supplementation.
METHODS: After 18 days of intermittent total parenteral nutrition, acute onset of severe fetal brain hemorrhage developed.
METHODS: After acute onset of fetal brain hemorrhage, the patient underwent an emergency cesarean section at 25 + 3 weeks of gestation due to fetal non-reassuring fetal monitoring.
RESULTS: The Apgar score at birth was 0/0, and despite cardiopulmonary resuscitation, neonatal death was confirmed. After the baby was delivered, we checked the maternal upper abdominal cavity and found a massive adhesion in the small bowel to the abdominal wall near the liver and stomach with an adhesion band. The adhesion band, presumably a complication of previous hepatobiliary surgery, appeared to have caused small bowel obstruction. Adhesiolysis between the small bowel and abdominal wall was performed.
CONCLUSIONS: This case demonstrates that even relatively short-term total parenteral nutrition can cause severe fetal brain hemorrhage. Vitamin K supplementation is required for mothers who are expected to be vitamin K deficient, especially if they are on total parenteral nutrition for more than 3 weeks.
摘要：
背景：胎儿脑出血很少见。它主要由母体创伤或胎儿凝血障碍引起，但在某些情况下,维生素K缺乏可能是原因。
方法：我们描述了一名患有肠梗阻的孕妇，该孕妇由于口服饮食限制而容易缺乏维生素K，肠道吸收减少，和有限的静脉注射维生素K补充。
方法：间歇性全胃肠外营养18天后，严重胎儿脑出血急性发作。
方法：胎儿脑出血急性发作后，该患者在妊娠25+3周时接受了紧急剖宫产术,原因是胎儿监测不可靠.
结果：出生时的Apgar评分为0/0，尽管进行了心肺复苏，确认新生儿死亡。婴儿分娩后，我们检查了产妇上腹腔，发现小肠与肝脏和胃附近的腹壁有大量粘连，并有粘连带。粘合带,可能是先前肝胆手术的并发症，似乎导致了小肠梗阻。进行小肠和腹壁之间的粘连溶解。
结论：该病例表明，即使是相对短期的全胃肠外营养也可导致严重的胎儿脑出血。维生素K补充是需要谁是维生素K缺乏的母亲，特别是如果他们使用全胃肠外营养超过3周。
方法：我们描述了一名患有肠梗阻的孕妇，该孕妇由于口服饮食限制而容易缺乏维生素K，肠道吸收减少，和有限的静脉注射维生素K补充。
方法：间歇性全胃肠外营养18天后，严重胎儿脑出血急性发作。
方法：胎儿脑出血急性发作后，该患者在妊娠25+3周时接受了紧急剖宫产术,原因是胎儿监测不可靠.
结果：出生时的Apgar评分为0/0，尽管进行了心肺复苏，确认新生儿死亡。婴儿分娩后，我们检查了产妇上腹腔，发现小肠与肝脏和胃附近的腹壁有大量粘连，并有粘连带。粘合带,可能是先前肝胆手术的并发症，似乎导致了小肠梗阻。进行小肠和腹壁之间的粘连溶解。
结论：该病例表明，即使是相对短期的全胃肠外营养也可导致严重的胎儿脑出血。维生素K补充是需要谁是维生素K缺乏的母亲，特别是如果他们使用全胃肠外营养超过3周。
