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Intraperitoneal bleeds bring high mortality rate in infants

Victor Lewin - Thursday, July 16, 2015

For most mothers, the day they give birth is one of the most treasured memories of their lives. However, for some, the day is marred by trauma surrounding the birth process, due to complications during or immediately following the birth.

One of the most serious, but fortunately rare, complications is intra-abdominal injury to the infant. In most cases, the liver is damaged, resulting in internal hemorrhaging known as an intraperitoneal bleed.

The bleeding may be gradual or uncontrolled, but the end result is circulatory collapse. Obstetricians should be alert to the possibility of hepatic rupture if newborns appear in shock, pale, or even have a blue tint to their skin. They may have distended abdomens. Blood tests may indicate inexplicable anemia.

Babies that suffer from coagulation problems, hepatomegaly, those born prematurely or past their due date have a higher risk. The liver may also be lacerated by pulling on the ligaments that provide peritoneal support. Too much pressure near the costal margin can bring on the condition. Asphyxia that is treated by an especially robust resuscitative effort performed by unusual methods may also cause the deadly birth complication.

X-rays alone cannot diagnose the problem, but may show fluid in the peritoneal region that requires paracentesis. In order to save the infant's life, it is paramount that physicians quickly recognize the problem and stabilize the baby with blood transfusions. Coagulopathy can be counteracted by transfusing platelets or with frozen plasma.

If the physician fails to identify and rapidly address the problem of an intraperitoneal bleed, the infant will die. If you have lost a child due to a doctor's negligence or failure to monitor your baby, you may wish to seek legal remedies for your loss.

Source: Medscape.com, "Intra-Abdominal Injury," accessed July 10, 2015

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