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Related Experiment Videos

Coagulation failure in babies with rhesus isoimmunization.

E Hey, P Jones

    British Journal of Haematology
    |July 1, 1979
    PubMed
    Summary

    Severe hemolytic disease in newborns can cause coagulation failure and defibrination, leading to fatal hemorrhages. Early screening and intensive factor replacement may reduce mortality in at-risk infants.

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    Area of Science:

    • Neonatal Medicine
    • Hematology
    • Pediatric Coagulation

    Background:

    • Hemolytic disease of the newborn (HDN) is a significant concern.
    • Coagulation abnormalities can complicate severe cases of HDN.

    Purpose of the Study:

    • To investigate coagulation status in newborns with a positive Coombs test.
    • To identify risk factors and potential interventions for coagulation failure in severe HDN.

    Main Methods:

    • Prospective study of 73 newborns with positive Coombs test.
    • Serial assessment of coagulation parameters, including factors II, VII, IX, X, and fibrinogen.
    • Monitoring of platelet counts and fibrin degradation products.

    Main Results:

    • No coagulation abnormalities in mild HDN.
    • Seven of 36 severe HDN cases showed transient defibrination.
    • Six severe HDN cases presented with coagulation failure at birth, characterized by low platelets and multiple factor deficiencies.
    • Exchange transfusion temporarily corrected factor deficiency but led to defibrination.
    • Five of these six infants died from hemorrhage into the lung or brain.

    Conclusions:

    • Severe HDN can lead to life-threatening coagulation failure and consumption coagulopathy.
    • Low vitamin-K dependent factor levels suggest in utero liver damage.
    • Early screening and proactive factor replacement are crucial for reducing mortality in at-risk infants.

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