An Unusual Cause Of Neonatal Shock: A Case Report

The authors present a premature male neonate who developed subcapsular hematoma of the liver (SHL) secondary to birth trauma during the delivery process. During cesarean section, it was discovered that the infant had suffered birth trauma to the abdomen that caused intra-abdominal hemorrhage, resulting in hypovolemic shock. It was diagnosed as SHL upon abdominal ultrasound. This premature newborn infant presented with hypotension and metabolic acidosis secondary to internal hemorrhage. He was managed with volume replacement including packed red blood cells (pRBC), fresh frozen plasma and cryoprecipitate transfusions. The infant's clinical condition improved gradually, and he went home without any problems at 36 weeks of corrected gestational age. On follow-up visits, he was found to be growing and developing appropriately. High index of suspicion, appropriate work-up and prompt treatment of shock were the key steps in the management of this infant.