Study of some hemostatic factors in premature infants with respiratory distress syndrome [type I]

ABSTRACT

Respiratory distress syndrome [RDS] and its complications are responsible for a large percentage of neonatal morbidity and mortality. Hemostatic disturbances are frequently observed in sick preterm infants. Disseminated intravascular coagulation [DIC] usually follows the development of RDS or the establishment of severe sepsis. The aim of the present study was to identify the frequency of DIC and consumptive thrombocytopenia in premature infants with RDS, to assess the activity of the main natural inhibitors of coagulation [Antithrombin III [ATIII] and Protein C [PC]], and to correlate the clinical findings of possible relation to DIC with the laboratory markers of DIC in the investigated preterm infants. The study was conducted on 50 premature infants with RDS and 10 normal preterm infants as a control group. Infants were subjected to full monitoring of their clinical status, vital signs and blood gases. Coagulation study included measurement of prothrombin activity, activated partial thromboplastin time [APTT], serum fibrinogen, fibrin degradation products [FDPs], the activity of antithrombin Ill and protein C. Analysis of the results showed incomplete development of the coagulation system in preterm infants as indicated by decreased prothrombin activity %, the prolonged APTT, decreased ATIII and PC activity percentages. There was a significant reduction of platelet count, ATIII and PC activity % in the group of preterm infants with RDS. There was a significant correlation between the severity of RDS and the hemocoagulative parameters of DIC. Eight [16%] of the preterm infants with RDS had abnormal results suggestive of DIC. Six [12%] of our patients had compensated DIC and seven [14%] of them had consumptive thrombocytopenia