Fetal Encephalomalacia Secondary to Acute Maternal Blood Loss: A Case Study

Fetal neurons are sensitive to ischemia which could happen secondary to acute maternal blood loss. The damage to the fetal brain with loss of brain neurons in early gestation leads to encephalomalacia. We describe here a case report of fetal encephalomalacia secondary to acute maternal blood loss. A 23-year-old gravida 3, para 2 woman sustained a forearm laceration at 18 weeks of gestation. Her hemoglobin dropped to 7.9 mg/dL. A surgical laceration repair was completed, and she was transfused with blood. At the OB visit the following week, her fetal US showed abnormal brain, evident by the increased size of the lateral ventricles. A follow-up MRI at 30 weeks of gestation confirmed fetal encephalomalacia. A complete investigation, including free cell maternal DNA for chromosomal anomalies, TORCH infection, and Covid PCR, all were negative. We concluded from the case that any history of significant acute maternal blood loss that required blood transfusion should necessitate a fetal ultrasound to look for fetal well-being, especially for any brain structural changes in the developing brain.