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Related Experiment Videos

Neonatal coagulation: normal physiology and pathophysiology.

G R Buchanan

    Clinics in Haematology
    |February 1, 1978
    PubMed
    Summary
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    Neonates, especially premature infants, face bleeding risks due to immature hemostasis. Identifying causes through history, exam, and careful lab interpretation is key for managing neonatal hemorrhage.

    Area of Science:

    • Neonatal Medicine
    • Hematology
    • Pediatric Critical Care

    Background:

    • Newborn infants, particularly premature ones, possess a hemostatic system that may be insufficient to cope with neonatal complications.
    • These infants are susceptible to serious or life-threatening local or diffuse hemorrhage.
    • Understanding neonatal coagulation peculiarities is crucial for accurate diagnosis.

    Purpose of the Study:

    • To review the hemostatic challenges in newborn infants.
    • To discuss the diagnosis and management of neonatal hemorrhage.
    • To highlight difficulties in seriously ill neonates.

    Main Methods:

    • Review of clinical history and physical examination for predisposing factors.
    • Interpretation of screening laboratory tests considering neonatal coagulation physiology.

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  • Evaluation of diagnostic and therapeutic approaches for specific conditions.

    • Main Results:

    • Vitamin K deficiency and hemophilia are generally manageable in healthy-appearing neonates.
    • Seriously ill neonates with sepsis or respiratory distress syndrome present diagnostic and therapeutic challenges.
    • Disseminated intravascular coagulation (DIC) is common in critically ill neonates, often with unsuccessful transfusion therapy.
    • Fatal intravascular hemorrhage can occur with few identifiable hemostatic abnormalities, rendering transfusion futile.

    Conclusions:

    • Neonatal hemorrhage requires careful evaluation, considering the unique hemostatic mechanisms of newborns.
    • Management is complex in critically ill infants, with DIC posing significant challenges.
    • Certain cases of neonatal hemorrhage remain difficult to treat effectively, even with transfusions.