Related Experiment Videos
Coagulation abnormalities in low birth weight infants with peri-intraventricular hemorrhage
M Amato1, J C Fauchere, U Hermann
1Department of Perinatal Medicine, University Clinic of Obstetrics and Gynecology, Berne, Switzerland.
Insights
Preterm infants under 30 weeks gestation with lower fibrinogen and platelet counts face higher risks of peri-intraventricular hemorrhage (PIVH). These hemostatic issues are key factors in PIVH incidence and severity.
Area of Science:
- Neonatal Medicine
- Pediatric Neurology
- Hematology
Background:
- Peri-intraventricular hemorrhage (PIVH) is a significant complication in preterm infants.
- Hemostatic abnormalities may contribute to PIVH development and severity.
Purpose of the Study:
- To investigate the relationship between coagulation status and the incidence/severity of PIVH in preterm infants.
- To identify specific coagulation parameters associated with PIVH in very preterm neonates.
Main Methods:
- Prospective study of 54 preterm infants (<35 weeks gestation).
- Coagulation analyses (fibrinogen, prothrombin time, thrombin time, platelet count) performed.
- Real-time ultrasound (Echo Scanner) used to document PIVH.
- Comparison of coagulation values between infants with and without PIVH, and by PIVH grade.
Main Results:
- 38% of infants developed definite PIVH.
- Infants <30 weeks gestation with PIVH had significantly lower fibrinogen levels (p<0.03).
- Lower platelet counts correlated with higher PIVH grades (Grade 3-4 vs. Grade 1-2, p<0.02).
Conclusions:
- Hemostatic abnormalities, particularly low fibrinogen and platelet counts, are co-factors in neonatal PIVH.
- These findings are most pronounced in very preterm infants (<30 weeks gestation).
- Coagulation status is critical in managing and potentially preventing PIVH in high-risk neonates.
Abstract:
Fifty-four appropriate for gestational age preterm infants (less than 35 weeks gestation) were followed prospectively from birth with coagulation and real-time ultrasound studies. Coagulation analyses included fibrinogen, prothrombin time, thrombin time and platelet count. The occurrence of peri-intraventricular hemorrhage (PIVH) was documented by portable 5 MHz Echo Scanner. Definite PIVH was present in 21 babies (38%). Coagulation studies showed especially lower values of fibrinogen levels in babies of less than 30 weeks gestation compared to a control group without PIVH (p less than 0.03). Furthermore, significant correlation was observed in these patients between platelet count and degree of PIVH. Infants with Grade 3 and 4 PIVH had lower platelet count than infants with less severe bleeding (Grade 1 and 2) (p less than 0.02). These data suggest that hemostatic abnormalities play a major role as co-factor in the incidence and severity of neonatal PIVH in very low birth weight infants of less than 30 weeks gestation.