J Korean Soc Ultrasound Med.  2008 Sep;27(3):135-138.

Sonographic Diagnosis of Fetal Intracranial Hemorrhage in a Gravida on Warfarin Therapy

• Choi HM
• Lee SS
• Park SH

Abstract

A 34-year-old Korean woman who had been taking warfarin for 14 years after mitral valve replacement became pregnant. She was heparinized betwen 6 and14 weeks of gestation and was then restarted on oral anticoagulants. At 32 weeks of gestation, fetal ultrasonography revealed overt enlargement of the left lateral ventricles. There was an echogenic mass in the right hemisphere with mild ventricular enlargement. An elective repeat cesarean section was performed. Three days later, the neonate underwent a Burr-hole procedure, from which bloody fluid was drained and the intracranial hemorrhage was confirmed. We must keep in mind the severe adverse fetal outcomes associated with warfarin-induced fetal intracranial hemorrhage during pregnancy. Despite its therapeutic advantages, regular fetal monitoring, ultrasonography, and management of prothrombin time are needed.

Keyword

Fetal intracranial hemorrhage; Warfarin; Pregnancy

MeSH Terms

Adult
Anticoagulants
Cesarean Section, Repeat
Female
Fetal Monitoring
Heparin
Humans
Infant, Newborn
Intracranial Hemorrhages
Lateral Ventricles
Mitral Valve
Pregnancy
Prothrombin Time
Ultrasonography, Prenatal
Warfarin
Anticoagulants
Heparin
Warfarin