Practical aspects of management of newborn with venous thrombosis
The aim is to analyze clinical, laboratory, instrumental diagnostic methods, treatment tactics and management of newborn children of different gestation periods with thrombosis.
Material and methods. 65 newborn children with thrombosis were examined. Of these, 44 full-term and 21 premature babies. Thrombosis of various localization was detected in 22 children in the first and 43 children in the second weeks of life. The control group consisted of 31 full-term newborn babies and 20 premature babies without thrombosis.
Results. Venous thrombosis was detected in all observed children of the main group 65 (100%). The frequency of catheter-associated thrombosis in them was 50/65 (76.9%), but only 11/65 (16.9%) newborns developed clinical symptoms of thrombosis. Thrombosis without clinical manifestations occurred in 54/65 (83.1%) children. They were detected only during ultrasound examination. The most frequent localization of blood clots was thrombosis of the portal vein branches – in 46/65 (70.8%). Vascular thrombi of other localization were found in 19/65 (29.2%) of cases (thrombosis of the common iliac vein, including in combination with thrombosis of the femoral vein, renal veins, brachial vein thrombosis, and one child had a left atrial thrombus). Deficiency of natural anticoagulants was detected in 7/65 (10.8%) children with thrombosis. There was no statistically significant difference in hemostasis parameters of full-term and premature infants with thrombosis (p>0.05). There are no significant differences in these parameters in children with and without thrombosis. This proves once again that the low sensitivity of the traditional testing of coagulation to hemostasis disorders in children with thrombosis makes laboratory diagnostics uninformative. Approaches to therapy were determined by the localization of the thrombus, the degree of occlusion of the vessel, impaired function of damaged tissues, physiological features of hemostasis of newborns, pathological changes in it.
Conclusion. The introduction of ultrasound research methods into clinical practice has expanded the possibilities of diagnostic search in newborns with thrombosis and allowed them to be detected at the preclinical stage. All children from risk groups for the development of thrombosis are shown to have ultrasound with a doppler for early diagnosis and timely therapy of thrombosis.
Keywords:newborns; catheter-associated thrombosis; anticoagulant therapy; ultrasound examination
Funding. The study had no sponsor support.
Conflict of interest. The authors declare no conflict of interest.
For citation: Mikheeva I.G., Larina L.E., Dubenok S.Yu., Kurasova O.B., Belyaeva I.A., Kruglyakov A.Yu., Tsvetnova R.G., Iakovleva A.A., Kuznetsova Yu.A., Fedoseeva М.М., Pokhvashcheva P.Yu. Practical aspects of management of newborn with venous thrombosis. Neonatologiya: novosti, mneniya, obuchenie [Neonatology: News, Opinions, Training]. 2022; 10 (2): 21–8. DOI: https://doi.org/10.33029/2308-2402-2022-10-2-21-28
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