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. 1971 Feb;46(245):38–45. doi: 10.1136/adc.46.245.38

Haemostatic Failure in Babies with Rhesus Isoimmunization

Judith M Chessells, J S Wigglesworth
PMCID: PMC1647573  PMID: 5103055

Abstract

Platelet counts, fibrinogen levels, thrombotest, thromboplastin generation screening test, thrombin ratio, and titre of circulating fibrin degradation products, were measured in 30 infants with Rh isoimmunization, of whom 5 had a bleeding tendency clinically, and 8 had laboratory evidence of disturbed haemostasis.

At necropsy intravascular fibrin deposits were found in the tissues of 3 out of 4 babies who died with haemorrhage.

An additional retrospective survey indicated that haemorrhage had been a major factor in causing death in 10 out of 18 newborn babies who died with rhesus isoimmunization in the period 1967-69.

Sites of haemorrhage at necropsy were mainly intracranial (subarachnoid and intracerebral) and intrapulmonary, with microscopical evidence of intravascular fibrin deposits in 5 cases.

It is concluded that disseminated intravascular coagulation is a major cause of haemostatic failure in babies with rhesus isoimmunization, but that disturbed hepatic synthesis of coagulation factors may also play a part.

Babies at risk from haemostatic failure are those with cord Hb below 7 g/100 ml. It is suggested that a platelet count should be performed as an initial investigation on all such infants.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

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