Objective: To present a case of fetal intracranial injuries in a preterm infant after maternal motor vehicle accident and to review the relevant literature.
Design: Case report.
Setting: Neonatal and pediatric intensive care unit of a children's hospital.
Patient: Preterm infant (gestational age, 30-6/7 wks) with intracranial injuries after maternal motor vehicle accident.
Results: Whereas the mother had only a closed femur fracture, her infant sustained subdural, subarachnoid, and intracerebral hemorrhages in the left parietal and temporal lobes most likely attributable to direct fetal trauma. Massive fetomaternal hemorrhage may have led additionally to hypoxia-ischemia contributing indirectly to the injury. At the last follow-up visit (chronological age, 20 months; corrected age, 18 months), there was evidence of a persistent right-sided hemiparesis in an otherwise normally developed infant.
Conclusions: Motor vehicle accidents during pregnancy can be associated with fetal mortality and significant morbidity, even in the absence of severe maternal injuries. Direct (hemorrhagic) and indirect (hypoxic-ischemic) intracranial injuries should be actively sought with appropriate imaging studies.