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Neonatal Hemostasis

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Benign Hematologic Disorders in Children

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Abstract

Hemostasis is the first step of wound healing responsible for the transformation of free-flowing blood to a gel consistency and therefore stopping a bleed. Hemostasis is an evolving process that begins early in fetal development and continues throughout life. A delicate balance of both bleeding and clotting factors exists and, if tipped in the wrong direction, results in life-threatening hemorrhage or thrombus formation. Nevertheless, hemostasis in healthy neonates is functionally stable and protective with no tendency toward excessive bleeding or clotting. However, sick preterm infants have disruption in this hemostatic balance and are at increased risk of morbidity from hemorrhage and/or thrombosis. The hemostatic system includes platelets and von Willebrand factor (vWF) responsible for primary hemostasis; coagulation factors required for thrombin activation and stable clot formation of secondary hemostasis; natural inhibitors of coagulation to stop clot propagation before leading to excessive thrombosis; and fibrinolysis to dissolve clots after tissue healing occurs. There is constant feedback, both negative and positive, keeping this system at a balance.

This chapter will address:

  • Normal development of the neonatal hemostatic system

  • Data tables with normal ranges in neonates

  • Blood-sampling challenges that result in error

  • Inherited disorders of hemostasis and thrombosis that can present in the newborn period

  • Anticoagulation treatment options for neonates

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Author information

Authors and Affiliations

  1. University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA

    Lincy Thomas

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  1. Lincy Thomas
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Editors and Affiliations

  1. Department of Pediatrics, University of Texas Health Science Center, San Antonio, TX, USA

    Deepak M. Kamat

  2. Department of Pediatrics, Division of Hematology-Oncology, The University of Texas Health Science Center, San Antonio, TX, USA

    Melissa Frei-Jones

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Thomas, L. (2021). Neonatal Hemostasis. In: Kamat, D., Frei-Jones, M. (eds) Benign Hematologic Disorders in Children. Springer, Cham. https://doi.org/10.1007/978-3-030-49980-8_23

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  • DOI: https://doi.org/10.1007/978-3-030-49980-8_23

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-49979-2

  • Online ISBN: 978-3-030-49980-8

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