Prenatal Diagnosis of Fetal Encephalomalacia after Maternal Diabetic Ketoacidosis
Abstract Introduction Encephalomalacia in a developing fetus is a rare and devastating neurological finding on radiologic imaging. Maternal diabetic ketoacidosis (DKA) can lead to metabolic and vascular derangements which can cause fetal encephalomalacia. Case We report the...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Thieme Medical Publishers, Inc.
2014-11-01
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| Series: | American Journal of Perinatology Reports |
| Subjects: | |
| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0034-1395990 |
| _version_ | 1818458579606175744 |
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| author | Rozalyn Love Amy Lee April Matiasek William Carter Marissa Ylagan |
| author_facet | Rozalyn Love Amy Lee April Matiasek William Carter Marissa Ylagan |
| author_sort | Rozalyn Love |
| collection | DOAJ |
| description | Abstract
Introduction Encephalomalacia in a developing fetus is a rare and devastating neurological finding on radiologic imaging. Maternal diabetic ketoacidosis (DKA) can lead to metabolic and vascular derangements which can cause fetal encephalomalacia.
Case We report the case of a 27-year-old pregnant woman with White's Class C diabetes mellitus who presented in the 25th week of gestation with DKA. Four weeks after her discharge, marked fetal cerebral ventriculomegaly was noted on ultrasound. A subsequent fetal magnetic resonance imaging (MRI) demonstrated extensive, symmetric cystic encephalomalacia, primarily involving both cerebral hemispheres. The pregnancy was continued with close fetal and maternal surveillance. The patient underwent a repeat cesarean delivery in her 37th week. The infant had a 1 month neonatal intensive care unit stay with care rendered by a multiple disciplinary team of pediatric subspecialists. The postnatal course was complicated by global hypotonia, poor feeding, delayed development and ultimately required anticonvulsants for recurrent seizures. He died at the age of 9 months from aspiration during a seizure.
Discussion Although the maternal mortality from DKA has declined, DKA still confers significant neurological fetal morbidity to its survivors. |
| first_indexed | 2024-12-14T23:00:42Z |
| format | Article |
| id | doaj.art-078c0ccf75314d418fdb650c825dcd0c |
| institution | Directory Open Access Journal |
| issn | 2157-6998 2157-7005 |
| language | English |
| last_indexed | 2024-12-14T23:00:42Z |
| publishDate | 2014-11-01 |
| publisher | Thieme Medical Publishers, Inc. |
| record_format | Article |
| series | American Journal of Perinatology Reports |
| spelling | doaj.art-078c0ccf75314d418fdb650c825dcd0c2022-12-21T22:44:27ZengThieme Medical Publishers, Inc.American Journal of Perinatology Reports2157-69982157-70052014-11-010402e97e10010.1055/s-0034-1395990Prenatal Diagnosis of Fetal Encephalomalacia after Maternal Diabetic KetoacidosisRozalyn Love0Amy Lee1April Matiasek2William Carter3Marissa Ylagan4Department of Obstetrics and Gynecology, Naval Medical Center, Portsmouth, VirginiaDepartment of Obstetrics and Gynecology, Langley Air Force Base, VirginiaDepartment of Radiology, Naval Medical Center. Portsmouth, VirginiaDepartment of Radiology, Naval Medical Center. Portsmouth, VirginiaDepartment of Obstetrics and Gynecology, Naval Medical Center, Portsmouth, VirginiaAbstract Introduction Encephalomalacia in a developing fetus is a rare and devastating neurological finding on radiologic imaging. Maternal diabetic ketoacidosis (DKA) can lead to metabolic and vascular derangements which can cause fetal encephalomalacia. Case We report the case of a 27-year-old pregnant woman with White's Class C diabetes mellitus who presented in the 25th week of gestation with DKA. Four weeks after her discharge, marked fetal cerebral ventriculomegaly was noted on ultrasound. A subsequent fetal magnetic resonance imaging (MRI) demonstrated extensive, symmetric cystic encephalomalacia, primarily involving both cerebral hemispheres. The pregnancy was continued with close fetal and maternal surveillance. The patient underwent a repeat cesarean delivery in her 37th week. The infant had a 1 month neonatal intensive care unit stay with care rendered by a multiple disciplinary team of pediatric subspecialists. The postnatal course was complicated by global hypotonia, poor feeding, delayed development and ultimately required anticonvulsants for recurrent seizures. He died at the age of 9 months from aspiration during a seizure. Discussion Although the maternal mortality from DKA has declined, DKA still confers significant neurological fetal morbidity to its survivors.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0034-1395990diabetic pregnancydiabetic ketoacidosisencephalomalacia |
| spellingShingle | Rozalyn Love Amy Lee April Matiasek William Carter Marissa Ylagan Prenatal Diagnosis of Fetal Encephalomalacia after Maternal Diabetic Ketoacidosis American Journal of Perinatology Reports diabetic pregnancy diabetic ketoacidosis encephalomalacia |
| title | Prenatal Diagnosis of Fetal Encephalomalacia after Maternal Diabetic Ketoacidosis |
| title_full | Prenatal Diagnosis of Fetal Encephalomalacia after Maternal Diabetic Ketoacidosis |
| title_fullStr | Prenatal Diagnosis of Fetal Encephalomalacia after Maternal Diabetic Ketoacidosis |
| title_full_unstemmed | Prenatal Diagnosis of Fetal Encephalomalacia after Maternal Diabetic Ketoacidosis |
| title_short | Prenatal Diagnosis of Fetal Encephalomalacia after Maternal Diabetic Ketoacidosis |
| title_sort | prenatal diagnosis of fetal encephalomalacia after maternal diabetic ketoacidosis |
| topic | diabetic pregnancy diabetic ketoacidosis encephalomalacia |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0034-1395990 |
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