Multiple arterial thrombi and in utero leg gangrene in an infant of a diabetic mother.

This case report is of an infant of a diabetic mother who presented with lower extremity gangrene occurring in utero that necessitated a below the knee amputation at 3 hours of age. The association of venous thrombi in infants of diabetic mothers (IDMs) has been firmly established. However, in this case the thrombi were arterial and resulted in gangrene during the second trimester of gestation. The reason for the increased tendency to develop thrombi in infant of diabetic mothers has not been elucidated. We did an extensive workup of this infant to look for a cause of the arterial thrombus. The only abnormality found was in the plasminogen activity, which was significantly lower than the reference values for infants of the same gestational and chronological age. The significance of this finding on the propensity of IDMs to develop thrombi is discussed.