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Birth trauma may lead to intra-abdominal hemorrhage

Some North Carolina parents may be interested in learning about infant intra-abdominal hemorrhage during the delivery process. This type of injury is not common, but may lead to significant blood loss. When this happens, a quick response by the medical team might avert serious complications or death.

The most common cause of hemorrhage is hepatic rupture due to a hematoma under the capsule of the liver. As the hematoma fills with blood it enlarges. It may reach a size of four to five centimeters before rupture occurs. Occasionally, the liver may be lacerated or splenic injury and bleeding may result. When bleeding occurs, the infant may appear pale, display an anemia of unknown origin and abdominal distension. Without intervention, such symptoms may progress to shock and circulatory collapse.

Hematoma may result from coagulation problems and hepatic enlargement. Premature and postmature infants are predisposed to hematoma. Infants who experience asphyxia during birth may be exposed to vigorous and nontraditional resuscitation resulting in hematoma. Health care professionals who note the symptoms associated with intra-abdominal bleeding or an unexplained anemia may wish to use ultrasound or CT confirmation of a hematoma. With hemorrhage, rapid stabilization of the infant using blood transfusion and an evaluation for coagulation defects are in order.

Without intervention, intra-abdominal hemorrhage may lead to death. The obstetrician or neonatologist who performs resuscitation may question the cause of the newborn injury. If proper steps are not taken, the parents may wish to speak to an attorney concerning whether a malpractice suit should be filed against the health care professionals involved in the birth and postpartum care of the infant. An attorney may review the case with the assistance of medical experts to determine if the appropriate standard of care was not adhered to.

Source: Medscape, "Intra-Abdominal Injury", Nirupama Laroia, Feb. 2, 2015

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