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Neonatal aortic thrombosis: recent experience.

G N Vailas, R T Brouillette, J P Scott

    The Journal of Pediatrics
    |July 1, 1986
    PubMed
    Summary
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    Severe perinatal asphyxia may predispose infants to aortic thrombosis. While ultrasonography aids diagnosis and monitoring, major thrombosis with anuria is fatal, highlighting the need for early intervention in neonatal aortic thrombosis.

    Area of Science:

    • Neonatal Medicine
    • Pediatric Cardiology
    • Vascular Surgery

    Background:

    • Umbilical artery catheterization is a common neonatal procedure.
    • Aortic thrombosis is a serious complication associated with umbilical artery catheterization.
    • Perinatal asphyxia is a potential risk factor for aortic thrombosis in neonates.

    Purpose of the Study:

    • To evaluate the clinical course, diagnostic methods, management strategies, and outcomes of aortic thrombosis in infants.
    • To investigate the association between perinatal asphyxia and aortic thrombosis.
    • To assess the utility of diagnostic modalities like ultrasonography and radionuclide renography-scintigraphy.

    Main Methods:

    • Retrospective review of 20 cases of aortic thrombosis diagnosed via ultrasonography or aortography over 4 years.

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  • Analysis of patient data including perinatal history, clinical presentation, diagnostic findings, therapeutic interventions, and outcomes.
  • Correlation of diagnostic imaging findings with clinical severity and treatment response.

    • Main Results:

    • Fourteen of 20 infants had severe perinatal asphyxia.
    • Ultrasonography was effective for thrombus visualization and monitoring treatment response.
    • Renal function was impaired in all scanned patients (n=11).
    • Minor thrombosis cases (hypertension) resolved without specific therapy.
    • Moderate thrombosis cases survived with various treatments, including heparin and surgery.
    • Streptokinase therapy led to resolution in 2 of 3 infants with moderate thrombosis.
    • Major thrombosis with anuria resulted in mortality in all 5 affected infants.
    • Hepatic infarction was observed in 3 of 3 autopsied cases.

    Conclusions:

    • Severe perinatal asphyxia is strongly associated with neonatal aortic thrombosis.
    • Ultrasonography is a valuable tool for diagnosing and managing aortic thrombosis.
    • Outcomes are dependent on thrombosis severity, with anuria indicating a poor prognosis.
    • Prompt diagnosis and appropriate management are crucial for improving survival rates in neonatal aortic thrombosis.