Consumed ischemia of lower limbs in the newborn: a case report.

The limb ischemia is a rare phenomenon in the newborn. It is most often a postnatal ischemia secondary to arterial or venous catheterization, to neonatal infection. Maternal diabetes is most often implicated. The diagnosis implies an urgent situation which may result in extremity gangrene and ultimate loss of limb.

The limb ischemia is a rare phenomenon in the newborn. The first description is attributed to Martini cited in the literature by Blank et al.,[1] and since then more than one hundred cases have been reported.[1]

We report a case of ischemia consumed of right lower limb in a premature newborn [Figure 1], appeared at J+3 after a vaginal delivery at home. The mother, 40-year-old, is not diabetic, with no concept of taking drugs or toxic plants during pregnancy.

Figure 1a

Premature newborn with necrosis of the right foot

Aspect of the right foot with extensive necrosis extended to the lower third of the leg

It is most often a postnatal ischemia secondary to arterial or venous catheterization, to neonatal infection, to a hypercoagulability or to dehydration.[12]

There are many contributing factors like malformation, infectious, metabolic or obstetric etiology.[1] Maternal diabetes is most often implicated.[3] The common element in all these causative factors is arterial insufficiency leading to limb ischemia. This deficiency is the result of either intrauterine compression or arterial thrombosis.[3]

This clinical picture must be differentiated from ischemia in utero that occurs before birth, only 20 cases have been reported in the literature.[13]