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[Neonatal hypoxia and hemocoagulative changes].

A Fichera1, G Praticò, F Sciacca

  • 1Istituto di Clinica Pediatrica II, Università di Catania, Italia.

La Pediatria Medica E Chirurgica : Medical and Surgical Pediatrics
|November 1, 1989
PubMed
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Hypoxia in newborns can cause coagulation issues, leading to bleeding. Specific lab tests are crucial for early detection and management in infants with respiratory distress syndrome or acute asphyxia.

Area of Science:

  • Neonatal Medicine
  • Hematology
  • Pediatric Critical Care

Background:

  • Hypoxia in newborns is frequently associated with coagulation abnormalities, including hemorrhagic manifestations.
  • These issues are particularly noted in postmature infants and those experiencing acute asphyxia at birth, respiratory distress syndrome (RDS), intra-uterine growth retardation (IUGR), and cyanotic congenital heart disease (CCHD).
  • The primary causes involve reduced synthesis or consumption of blood coagulation factors.

Purpose of the Study:

  • To examine anomalies in platelet count and function, global hemostasis tests, coagulation factors, and physiological inhibitors.
  • To review the literature and author studies on coagulation and fibrinolysis in hypoxic newborns.
  • To determine necessary laboratory investigations for different categories of hypoxic newborns.

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Main Methods:

  • Review of existing literature and author's own studies.
  • Examination of platelet number and function.
  • Analysis of global hemostasis tests, coagulation factors, physiological inhibitors, fibrinogenesis, and fibrinolysis.

Main Results:

  • Specific laboratory investigations are recommended based on the type of hypoxic condition.
  • For infants with RDS or acute asphyxia, platelet count, prothrombin time (PT), partial thromboplastin time (PTT), fibrinogen, factors V and VIII, and plasma D-dimer (PDF) determinations are deemed necessary during the first week of life.
  • In other hypoxic newborns (IUGR, CCHD, postmature infants), platelet count, PT, PTT, and serum PDF determinations may suffice.

Conclusions:

  • Consumption coagulopathy is a significant risk in newborns with RDS or acute asphyxia, necessitating comprehensive coagulation testing.
  • Tailored laboratory evaluations are appropriate for different hypoxic neonatal conditions to effectively assess coagulation abnormalities.
  • Early and appropriate laboratory assessment aids in managing potential bleeding risks in hypoxic neonates.