International Journal of Clinical Case Reports 2017, Vol.7, No.15, 62-66
62
Research Report Open Access
Benckiser Haemorrhage Reverouble Delivery Complication
Ragmoun Houssem
1
, Daadoucha Abdrahmen
2
, Benhlima Najeh
3
, Ajili Abir
1
1 Department of Obstetric Gynecology Ibn El Jazzar Hospital, University hospital assistant in gynecology obstetrics, Ibn El Jazzar street, Kairouan, 3100,
Tunisia
2 Department of Radiology Ibn El Jazzar Hospital, University hospital assistant in radiology, Ibn El Jazzar street, Kairouan, 3100, Tunisia
3 Department of Cardiology Ibn El Jazzar Hospital, University hospital assistant in cardiology, Ibn El Jazzar street, Kairouan, 3100, Tunisia
Corresponding author email
International Journal of Clinical Case Reports 2017, Vol.7, No.15 doi
Received: 17 Aug., 2017
Accepted: 30 Oct., 2017
Published: 03 Nov., 2017
Copyright © 2017
Ragmoun et al., This is an open access article published under the terms of the Creative Commons Attribution License, which permits
unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Preferred citation for this article:
Ragmoun H., Daadoucha A., Benhlima N., and Ajili A., 2017, Benckiser haemorrhage reverouble delivery complication, International Journal of Clinical
Case Reports, 7(15): 62-66 (doi
Abstract
Benckiser haemorrhage is a severe obstetrical urgency putting at risk the vital foetal prognosis with exsanguination. It is a
common complication of velamentous cord insertion. It is revealed by bleeding concomitant with the rupture of membranes. Thanks
to the Colour Doppler ultrasound progress, prenatal diagnosis is possible, allowing evacuating the foetus by prophylactic caesarean
section. We report a new case of Benckiser haemorrhage in a pupiparous revealed by acute foetal suffering with favourable evolution.
A review of literature allowed us to specify the diagnosis aspects and the treatment modalities in such a disease.
Keywords
Foetal haemorrhage; Velamentous cord insertion; Benckiser haemorrhage; A cute foetal suffering
Background
Benckiser's hemorrhage was first described in 1831 by R. Benckiser. It is a pure fetal haemorrhage resulting from
the tearing of one or more umbilical vessels occurring during the rupture of the membranes. This follows a
velmentous insertion of the cord. It is a rare obstetric accident, its frequency is estimated at 1/4000 deliveries
(Nohuz et al., 2015). Its prognosis is formidable. Indeed, despite the progress of neonatal resuscitation, the mortality
of this syndrome remains more than 50%. This pejorative prognosis can be explained in part by a delay or a lack of
knowledge of the diagnosis.
The aim of our work is to specify the means and the possibilities of an early prenatal diagnosis that can improve the
fetal prognosis.
1 Observation
Ms Z.O., Aged 30, second gesture, prim parous blood group. O positive, with no particular antecedents
noteworthy, pregnant at 39
weeks’ gestation,
followed 4 times by a gynecologist for placenta anterior low inserted
type I of the Bessis classification. She consulted us for the start of work. The examination at admission had found
an arterial tension at 12/8, an uterine height at 31 cm, uterine contractions present and regular at the rate of 3
contr./10mn. At the vaginal touch the cervix was open at 1 cm, the presentation was cephalic and the pouch of the
water was intact. Ultrasound monitoring showed a eutrophic fetus in cephalic presentation and a still low placenta
inserted. Fetal heart rhythm recording demonstrated a reactive tracing with a base frequency of 130 bps / min.
An amniotomy was performed at 4 cm following the occurrence of genital haemorrhage of medium abundance
made of bright red blood with the appearance at the fetal heart rhythm recording of repetitive and deep
decelerations (Figure 1). Benckiser's hemorrhage diagnosis was evoked and an emergency caesarean section was
performed, allowing the extraction of a boy of 3400 g of apgar 2/4/4 with intense mucosal skin pallor.
Neonatal resuscitation was started in the delivery room and continued in the neonatal department where a
biological check-up was performed and showed an anemia at 9.1 g / ml and an arterial PH at 7.18. A vascular
filling with serum albumin at a rate of 1 g / kg and a blood transfusion with two pockets of globular O-negative
pellets were performed. The development was favorable and the newborn had left the service on the 4
th
day of life.
