Neonatal symptomatic thromboembolism in Germany: two year survey

Abstract

Aims: To determine the incidence of neonatal thromboembolism in Germany.

Methods: Diagnostic imaging techniques, therapeutic modalities, and short term outcome were evaluated in a prospective nationwide two year case registry study.

Results: The reported incidence of symptomatic neonatal thromboembolism, diagnosed in most cases with Doppler ultrasonography, was 5.1 per 100000 births, with a total of 79 cases registered: renal venous thrombosis (n = 35); venous thrombosis (n = 25); and arterial vascular occlusion (n = 19). Fifty seven of 79 thromboses were associated with additional risk factors (central line n = 25, asphyxia n = 13, septicaemia n = 11, dehydration n = 6, maternal diabetes n = 2, cardiac disease n = 1). Inherited thrombophilia was also diagnosed in seven out of 35 cases investigated. Twenty three children received supportive treatment: 42 received heparin and in 13 neonates thrombolytic agents were administered. Most neonates (91%) survived; seven died.

Conclusion: Controlled multicentre studies are needed to obtain more information on treatment efficacy.

Figure 1

Different age distribution at time of diagnosis in renal venous thrombosis (RVT), venous thrombosis (VT), and arterial vascular occlusion (AT) in preterm or term neonates (median and SE values). Compared with preterm babies, term infants developed RVT (P= 0.002) or AT significantly earlier (P=0.009).

Figure 2

Treatment modalities of neonatal thromboembolism for arterial and venous sites.

Figure 3

Patency of neonatal thromboembolism according to arterial and venous sites.

Figure 4

Patency of neonatal thromboembolism according to different treatment modalities.