Neonatal Renal Failure After Maternal Motor Vehicle Accident.

Background: Motor vehicle accidents account for the majority of abdominal trauma in pregnancy and can result in fetal morbidity and mortality. With advancing gestation, the fetus becomes more vulnerable to injury.

Case presentation: A preterm neonate is born at 32 weeks' gestation via cesarean section due to placental abruption after maternal motor vehicle accident. Initially, the infant presented with anemia, thrombocytopenia, and acute kidney injury in the setting of renal contusions.

Results: Hyponatremia, acidosis, oliguria, and uremia progressed to frank anuric renal failure, requiring several months of hemodialysis before transition to peritoneal dialysis for chronic renal replacement therapy at home.

Conclusions: Fetal renal injury resulting in postnatal renal failure is a rare but potentially devastating complication of blunt abdominal injury during pregnancy. Sonographic and laboratory evaluation of a neonate with suspected in utero injury after maternal motor vehicle accident is imperative, as is a high index of suspicion for neonatal renal injury.