Management and Outcome in 32 Neonates with Thrombotic Events

Abstract

Objective. To determine the incidence, management, complications, and outcome in neonates with thrombotic events. Study Design. We performed a retrospective study of all neonates with thrombotic events admitted to our neonatal intensive care unit from January 2004 to July 2010. Results. Thrombotic events were identified in 32 of 4734 neonates (0.7%). Seven neonates were managed expectantly and 25 neonates received anticoagulant treatment. Complete resolution of the clot within 3 months of age was found in 68% (17/25) of the treated and in 86% (6/7) of the nontreated neonates. Major complications due to anticoagulant therapy occurred in 3/25 cases (12%) and included severe hemorrhage (n = 2) and abscess at the injection site (n = 1). Conclusion. Complete or partial clot resolution in neonatal thrombosis occurred in both the treated group and nontreated group. Randomized controlled trials are warranted to determine the optimal management in neonatal thrombosis.

Intrauterine Bilateral Upper Limb Gangrene and Cerebral Infarction in Preterm Infant: A Case Report and Literature Review

“…It is mandatory to administer Low Molecular Weight Heparin (LMWH) as an anticoagulant to prevent thrombus propagation or embolism [13,14]. In the present case, LMWH was administered and significant improvement in the right upper limb was recorded.…”

“…The infant in present study was administered low molecular weight heparin till discharge after one month. The infant was also given fresh frozen plasma to improve tissue perfusion and supply any deficient factor as it was recommended in few studies [1][2][3][10][11][12][13][14].…”

Thrombosis in the Neonatal Intensive Care Unit

“…7,8 These differences shift the neonate into a somewhat prothrombotic state, which is balanced by other factors preventing spontaneous thromboses in well neonates. 9 However, numerous acquired and prothrombotic disorders may disrupt this balance, placing a neonate at risk for developing a clinically significant thrombosis ( Table 2).…”

Neonatal haemostasis and the management of neonatal thrombosis

“…Although a thrombotic event may present with obvious signs relating its location, the presence of an occult thrombosis should be considered where there is prolonged sepsis or there is persisting thrombocytopenia with no obvious other cause (van Elteren et al, 2011).…”