A rare case of fetal extensive intracranial hemorrhage and whole-cerebral hypoplasia due to latent maternal vitamin K deficiency

J Neonatal Perinatal Med. 2018;11(2):191-194. doi: 10.3233/NPM-181745.


We present here a late preterm infant with extensive brain lesions resulting from vitamin K deficiency. A female infant was born after 35 weeks of gestation by emergent cesarean section because of non-reassuring fetal status. Her mother had severe eating disorder and recurrent vomiting since early pregnancy. She was immediately intubated and ventilated because she was extremely pale, hypotonic, and non-reactive. Cerebral magnetic resonance imaging immediately after birth showed intraparenchymal hemorrhage in the left frontal lobe and cerebellum, marked cerebral edema, and cerebellar hypoplasia. Coagulation studies of the infant showed hepaplastin test <5%, prolonged PT and APTT, and a marked elevation of protein induced by vitamin K absence or antagonist-II. This case highlighted a potential risk of intracranial bleeding due to maternal vitamin K deficiency and difficulty in its prediction before delivery. Vitamin K supplementation to high risk mothers might be indispensable for preventing severe fetal vitamin K deficiency. Even when coagulation studies in mothers is normal, it is imperative to provide vitamin K supplementation for total protection.

Keywords: Vitamin K deficiency; eating disorder; fetal bleeding; intracranial hemorrhage.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Feeding and Eating Disorders / blood
  • Feeding and Eating Disorders / complications*
  • Feeding and Eating Disorders / physiopathology
  • Female
  • Humans
  • Infant, Newborn
  • Intracranial Hemorrhages / blood
  • Intracranial Hemorrhages / diagnostic imaging
  • Intracranial Hemorrhages / etiology*
  • Maternal Nutritional Physiological Phenomena
  • Mothers*
  • Pregnancy
  • Pregnancy Complications, Hematologic / blood*
  • Pregnancy Complications, Hematologic / physiopathology
  • Prenatal Exposure Delayed Effects / blood*
  • Prenatal Exposure Delayed Effects / physiopathology
  • Treatment Outcome
  • Vitamin K / therapeutic use*
  • Vitamin K Deficiency / blood
  • Vitamin K Deficiency / complications*
  • Vomiting / complications


  • Vitamin K