Skip to main content
SpringerLink
Log in

Neonatal thrombosis

  • Symposium on hematology -II(Neonatal Hematology)
  • Published:
The Indian Journal of Pediatrics Aims and scope Submit manuscript

Abstract

Neonatal thrombosis is a serious event that can cause mortality or result in severe morbidity and disability. The most important risk factor for the development of thrombosis during the neonatal period is the presence of an indwelling central line and consequently the vessels involved tend to be those most frequently used for catheterization. Other documented risk factors for the development of neonatal thrombosis include asphyxia, septicemia, dehydration, maternal diabetes and cardiac disease. Main laboratory findings for the diagnosis of hypercoagulable states, include shortened aPTT, decreased levels of inhibitors (AT III, Protein C and Protein S), increased resistance to activated protein C, defective fibrinolysis (basal and after stimuli), increased levels of clotting factors (fibrinogen, factor VII, factor VIII, etc.), increased and/or hyperactive platelets, increased whole blood and/or plasma viscosity, Antiphospholipid antibodies and presence of prothrombotic molecular defects like FV Leiden, P20210 and MTHFR. Approximately 4% and 2% respectively of Caucasians are heterozygous for these gene defects. Their causative role in neonatal thrombosis is unknown but they may have a contributory role in the pathogenesis of thrombosis in neonates.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Schmidt B, Zipursky A. Thrombotic disease in newborn infants.Clin Perinatol 1984; 11:461–488.

    PubMed  CAS  Google Scholar 

  2. Andrew M, David M, Adams M, Ali K, Anderson R, Barnard Det al. Venous thromboembolic complications (VTE) in children: first analyses of the Canadian Registry of VTE.Blood 1994a; 83(5): 1251–1257.

    PubMed  CAS  Google Scholar 

  3. Symnasky MR, Fox HA. Umbilical vessel catheterization: indications, management and evaluation of the technique.J Pediatr 1972; 80: 820–826.

    Article  Google Scholar 

  4. Wigger HJ, Bransilver BR, Blanc WA. Thrombosis due to catheterization in infants and children.J Pediatr 1970; 76:1–11.

    Article  PubMed  CAS  Google Scholar 

  5. Al Kalay AL, Mazkereth R, Santulli T, Pomerance JJ. Central venous line thrombosis in premature infants: a case management and literature review.Am J Perinatol 1993; 10: 323–326.

    Google Scholar 

  6. Bertina RM, Koeleman BPCet al. Mutation in blood coagulation factor V associated with resistance to activated protein C.Nature 1994; 369: 64–67.

    Article  PubMed  CAS  Google Scholar 

  7. Poortet al. A common genetic variation in the 3 -untranslated region of the prothrombin gene is associated with elevated plasma prothrombin levels and an increase in venous thrombosis.Blood 1996; 88:3698–3703.

    PubMed  CAS  Google Scholar 

  8. Mingers AM, Philapitsch A, Schwarz HP, Zeitler P, Kreth HW. Polymorphonuclear elastase in patients with homozygous type I plasminogen deficiency and ligneous conjunctivitisSeminars in Thrombosis and Hemostasis 1998; 24: 605–612.

    Article  PubMed  CAS  Google Scholar 

  9. Tabbutt S, Griswold WR, Ogino MTet al Multiple thromboses in a premature infant associated with maternal phospholipid antibody syndrome. JPerinatol 1994; 14: 66–70.

    PubMed  CAS  Google Scholar 

  10. Helleret al. Abdominal venous thrombosis in neonates and infants: role of prothrombotic risk factorsa multicentre casecontrol study. For the Childhood Thrombophilia Study Group.Br J Haematol 2000; 111:534–539.

    Article  PubMed  CAS  Google Scholar 

  11. Junker Ret al. Prothrombin G20210A gene mutation and further prothrombotic risk factors in childhood thrombophilia.Arterioscler Thromb Vasc Biol 1999; 19: 2568–2572.

    PubMed  CAS  Google Scholar 

  12. Clagett GP, Ledesma DF. Commentary on Lawson JAet al. In situ vein grafts require more secondary procedures than reversed grafts after infrainguinal bypass surgery.Vascular Surgery Outlook 1999; 12(6): 21–22.

    Google Scholar 

  13. Walker ID, Greaves M, Preston F E. Guidelines: Investigation and management of heritable thrombophilia.Br J Haematol 2001; 114:512–528.

    Article  CAS  Google Scholar 

  14. Manco-Johnson MJ, Abshire TC, Jacobson LJ, Marlar RA. Severe neonatal protein C deficiency: prevalence and thrombotic risk. JPediatr 1991; 119: 793–798.

    Article  PubMed  CAS  Google Scholar 

  15. Payne RM, Martin TC, Bower RJ, Canter CE. Management and follow-up of arterial thrombosis in the neonatal period. JPediatr 1989; 114: 853–858.

    Article  PubMed  CAS  Google Scholar 

  16. Jaiyesimi F, Effiong CE, Lawson EAL. Congenital gangrene of an extremity in a Nigerian neonate.Clin Pediatr 1976; 15: 283–285.

    CAS  Google Scholar 

  17. Corrigan JI. Neonatal thrombosis and the thrombolytic system: Pathophysilogy and therapy.Am J Pediatr Hematol Oncol 1988; 10:83–91.

    PubMed  Google Scholar 

  18. Idowu J, Hertzler JH, Philipart AI. Occlusion of abdominal aorta in the newborn.J Pediatr Surg 1986; 21: 971–972.

    Article  PubMed  CAS  Google Scholar 

  19. Nazer H, Rajab AA, Qaryouti S, Zubrow A, Razi N, Askin SRet al. Neonatal limb gangrene and renal vein thrombosis.J Pediatr 1987; 146:429–431.

    Article  CAS  Google Scholar 

  20. Stravosky M, Iellin A, Spirer Z. Acute ischemia of the limb in a newborn treated successfully by thrombectomy.Am J Surg 1975; 129:337–340.

    Article  Google Scholar 

  21. Johnson D, Rosen JM, Khoury M, Stevenson D. Infarction of the upper limb associated with oligohydramnios and intrauterine compression.J Hand Surg 1988; 13A: 420–422.

    Google Scholar 

  22. Turnpenny PD, Stahl S, Bowers D, Bingham P. Peripheral ischemia and gangrene presenting at birth.Eeur J Pediatr 1992; 151:550–554.

    Article  CAS  Google Scholar 

  23. Schmidt B, Andrew M. Report of scientific and standardization subcommmittee on neonatal hemostasis. Diagnosis and treatment of neonatal thrombosis.Thromb Hemost 1992; 67: 381–382.

    CAS  Google Scholar 

  24. Andrew M, Paes B, Johnston M. Development of the human coagulation system in the neonate and young infants.Am J Pediatr Hematol Oncol 1990; 12: 95–104.

    PubMed  CAS  Google Scholar 

  25. Hathaway W, Corrigan J. Report of Scientific and Standardisation Subcommittee on Neonatal Haemostasis. Normal coagulation data for fetuses and newborn infants.Thrombosis and Haemostasis 1991; 65: 323–325.

    PubMed  CAS  Google Scholar 

  26. Schmidt B, Andrew M (for the subcommittee). Report of the Scientific and Standardization Subcommittee on Neonatal Hemostasis: Diagnosis and treatment of neonatal thrombosis.Thrombosis and Haemostasis 1992; 67: 381–382.

    PubMed  CAS  Google Scholar 

  27. Schmidt B, Buchanan M, Ofosu F, Brooker L, Hirsh J, Andrew M. Antithrombotic properties of heparin in a neonatal piglet model of thrombin induced thrombosisThrombosis and Haemostasis 1988; 60: 289–292.

    PubMed  CAS  Google Scholar 

  28. Andrew M, Marzinotto V, Massicotte P, Blanchette V, Ginsberg J, Brill-Edwards Pet al. Heparin therapy in pediatric patients: a prospective cohort studyPediatric Research 1994b; 35: 78–83.

    Article  PubMed  CAS  Google Scholar 

  29. Massicotte P, Adams M, Marzinotto V, Brooker LA, Andrew M. Low molecular weight heparin in pediatric patients with thrombotic disease: a dose finding studyJournal of Pediatrics 1996; 128:313–318.

    Article  PubMed  CAS  Google Scholar 

  30. Nohe N, Flemmer A, Rümler R, Praun M, Auberger K. The low molecular weight heparin dalteparin for prophylaxis and therapy of thrombosis in childhood: a report on 48 cases.Eur J Pediatr 1999; 158: S134-S139.

    Article  PubMed  CAS  Google Scholar 

  31. Chalmers EA, Gibson BES. Thrombolytic therapy in the management of paediatric thromboembolic disease.Brit J Hemat 1999; 104:14–21.

    Article  CAS  Google Scholar 

  32. Muller FM, Ehrenthal W, Hafner G, Schranz D. Purpura fulminans in severe congenital protein C deficiency: monitoring of treatment with protein C concentrate.Eur J Pediatr 1996; 155:20–25.

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Hematology, All India Institute of Medical Sciences, New Delhi, India

    R. Saxena (Professor), M. Kannan & V. P. Choudhry

Authors
  1. R. Saxena
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M. Kannan
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. V. P. Choudhry
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to R. Saxena.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Saxena, R., Kannan, M. & Choudhry, V.P. Neonatal thrombosis. Indian J Pediatr 70, 903–907 (2003). https://doi.org/10.1007/BF02730597

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02730597

Key words

Search

Navigation