Platelet dysfunction and coagulopathy in intraventricular hemorrhage in the premature infant

Richard E. Behrman, Emmalee S Bandstra, Iva B. Webb, John W. Wassenaar, John D. Reeder, Paulette S. Mehta, Donald V. Eitzman

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Abstract

We investigated platelet count, bleeding time, platelet aggregation, prothrombin time, activated partial thromboplastin time, and fibrinogen level in 58 very low-birth-weight infants during the first postnatal day to determine the relationship between hemostatic disorders and intraventricular hemorrhage. Thirty-two of the 58 infants (55%) were found to have periventricular-intraventricular hemorrhage by computerized tomography or autopsy. Nine patients (16%) had subarachnoid hemorrhage only and 17 (29%) had no evidence of intracranial hemorrhage. Infants with IVH had a significantly lower mean platelet count than did infants with no SAH/IVH. However, only five patients with IVH had initial thrombocytopenia. The IVH group had a mean bleeding time which was significantly prolonged compared to that of the group without SAH/IVH. Similarly, patients with IVH had a mean platelet aggregation response which was significantly diminished in comparison to that of patients with no SAH/IVH. Infants with IVH had a significantly longer mean PT than did infants with no SAH/IVH. In addition, babies with IVH had a significantly longer mean APTT compared to that of babies without SAH/IVH. The groups did not differ significantly with respect to fibrinogen levels. Three infants with IVH had disseminated-intravascular coagulation in the early neonatal period. These data suggest that disorders of platelet-capillary interaction and defects in the intrinsic and extrinsic coagulation pathways may play important roles in intraventricular hemorrhage in the premature infant.

Original languageEnglish (US)
Pages (from-to)599-605
Number of pages7
JournalThe Journal of pediatrics
Volume100
Issue number4
DOIs
StatePublished - Jan 1 1982
Externally publishedYes

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ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Behrman, R. E., Bandstra, E. S., Webb, I. B., Wassenaar, J. W., Reeder, J. D., Mehta, P. S., & Eitzman, D. V. (1982). Platelet dysfunction and coagulopathy in intraventricular hemorrhage in the premature infant. The Journal of pediatrics, 100(4), 599-605. https://doi.org/10.1016/S0022-3476(82)80766-X