Rossijskij Vestnik Perinatologii i Pediatrii (Nov 2022)

Features of platelet and plasma hemostasis in premature infants with hemorrhagic disorders

  • A. V. Budalova,
  • N. V. Kharlamova,
  • G. N. Kuzmenko,
  • I. G. Popova,
  • S. B. Nazarov

DOI
https://doi.org/10.21508/1027-4065-2022-67-5-41-47
Journal volume & issue
Vol. 67, no. 5
pp. 41 – 47

Abstract

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The research revealed features of platelet and plasma hemostasis indicators in children born before 32 weeks with hemorrhagic disorders in the early neonatal period, a method for predicting the development of intraventricular hemorrhage was developed.Material and methods. 132 premature newborns were examined, a detailed clinical blood test, a coagulogram with the determination of: activated partial thromboplastin time, prothrombin time, thrombin time, prothrombin index, fibrinogen content, D-dimer were performed on 1–3 days of life. The main group consisted of 58 children with hemorrhagic disorders, the comparison group included 74 children without hemorrhagic disorders.Results. Risk factors for the formation of hemorrhagic disorders in the early neonatal period were established: a lower gestational age of the child, lower Apgar scores at the end of the first and fifth minutes of life, the need for the introduction of an exogenous surfactant, and the use of higher concentrations of oxygen-air mixture during respiratory therapy. The features of hemostasis indicators in deep-premature newborns with hemorrhagic disorders in the early neonatal period were revealed: a lower number of platelets in the blood and higher platelet granularity, higher activated partial thromboplastin time, and a decrease in the prothrombin index. Based on the data obtained, a new method for predicting the formation of intraventricular hemorrhage in deeply premature newborns is proposed based on determining the concentration of total Ca2+ in the blood and the average concentration of platelet components. The results of this study can be used in intensive care units for newborns. Conclusion. The implementation of the obtained results in practice will help timely assess the state of hemostasis in deeply premature newborns to predict the development of intraventricular hemorrhages in the early neonatal period.

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