Changes in coagulation and fibrinolytic systems in high risk neonates

ABSTRACT

In order to evaluate the activity of coagulation and fibrinolytic systems in high risk neonates in relation to maternal high risk factors and its role in the development of neonatal complications, this prospective study was performed on 60 neonates and their mothers of high risk pregnancy [gestational diabetes[GDM], preeclamptic toxemia [PET] and antepartum hemorrhage [APHg]]. Their gestational ages ranged from 28-41 weeks. Twenty healthy neonates of matched gestational age, birth weight and sex and their mothers of normal pregnancy were studied as controls. Cord blood samples were taken from all the neonates for the evaluation of platelet count, platelet aggregation, antithrombin III activity [AT III], concentrations of fibrinopeptide A [FPA], D-dimers, tissue plasminogen activator[TPA] and plasminogen activator inhibitor-1[PAI-1]. The same investigations were done for the mothers. The high risk neonates were monitored. It was concluded that maternal high risk factors [GDM, PET, APHg] could tip the balance of the hemostatic system of their neonates toward hemorrhage or thrombosis with significant morbidity and mortality. Early recognition, diagnosis and specific treatment are important for controlling these complications. These data recommend the use of plasma replacement or anticoagulant in deficient neonates