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[Specificities of neonatal hemostasis and implications in pathologic situations].

Abstract

The haemostasis of healthy newborn differs from those of normal adult but remains well balanced without bleeding or thrombosis. However, this equilibrium is unstable, and the neonate is exposed to acquired or inherited haemostasis disorders that necessitate to be early diagnosed in order to be appropriately treated. Several studies provided reference ranges for haemostatic components in the foetus, the newborn and throughout childhood. The particularities of neonatal haemostasis are therefore better defined and contribute to further understand the pathophysiology and characteristics of hemorrhagic and thrombotic disorders that occur in newborns. Some examples of the impact of age on haemostasis are: the risk of neonatal alloimmune thrombocytopenia is high in the first newborn of a woman at risk since the involved antigens are fully expressed by foetal platelets; the newborn is at risk for vitamin K deficiency with bleeding due to poor transport of vitamin K across the placenta and low levels of coagulation factors II, VII, IX, X; the diagnosis of some inherited coagulation deficiencies can be difficult in the newborn due to physiologically low levels of coagulation factors; thrombotic events are rare in the healthy neonate, despite physiologically very low levels of several coagulation inhibitors; the pharmacokinetic and effects of antithrombotic agents are influenced by the specificities of haemostasis in neonates. This review will discuss about the foetal development of haemostasis until birth, and some implications regarding the pathophysiology, the diagnosis and the treatment of bleeding disorders in the human neonate.

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  • Publisher Full Text
  • Authors+Show Affiliations

    Service d'Hématologie-Hémostase, Hôpital Trousseau, 37044 Tours cedex 9, France. gruel@med.univ-tours.fr

    Source

    MeSH

    Adult
    Factor VII Deficiency
    Factor X Deficiency
    Female
    Fetal Development
    Fetal Diseases
    Fibrinolytic Agents
    Hemophilia B
    Hemostasis
    Hemostatic Disorders
    Humans
    Hypoprothrombinemias
    Infant, Newborn
    Infant, Newborn, Diseases
    Male
    Placenta
    Pregnancy

    Pub Type(s)

    English Abstract
    Journal Article

    Language

    fre

    PubMed ID

    20728815

    Citation

    Gruel, Y. "[Specificities of Neonatal Hemostasis and Implications in Pathologic Situations]." Archives De Pediatrie : Organe Officiel De La Societe Francaise De Pediatrie, vol. 17 Suppl 3, 2010, pp. S93-100.
    Gruel Y. [Specificities of neonatal hemostasis and implications in pathologic situations]. Arch Pediatr. 2010;17 Suppl 3:S93-100.
    Gruel, Y. (2010). [Specificities of neonatal hemostasis and implications in pathologic situations]. Archives De Pediatrie : Organe Officiel De La Societe Francaise De Pediatrie, 17 Suppl 3, pp. S93-100. doi:10.1016/S0929-693X(10)70907-6.
    Gruel Y. [Specificities of Neonatal Hemostasis and Implications in Pathologic Situations]. Arch Pediatr. 2010;17 Suppl 3:S93-100. PubMed PMID: 20728815.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - [Specificities of neonatal hemostasis and implications in pathologic situations]. A1 - Gruel,Y, PY - 2010/8/24/entrez PY - 2010/9/4/pubmed PY - 2011/1/20/medline SP - S93 EP - 100 JF - Archives de pediatrie : organe officiel de la Societe francaise de pediatrie JO - Arch Pediatr VL - 17 Suppl 3 N2 - The haemostasis of healthy newborn differs from those of normal adult but remains well balanced without bleeding or thrombosis. However, this equilibrium is unstable, and the neonate is exposed to acquired or inherited haemostasis disorders that necessitate to be early diagnosed in order to be appropriately treated. Several studies provided reference ranges for haemostatic components in the foetus, the newborn and throughout childhood. The particularities of neonatal haemostasis are therefore better defined and contribute to further understand the pathophysiology and characteristics of hemorrhagic and thrombotic disorders that occur in newborns. Some examples of the impact of age on haemostasis are: the risk of neonatal alloimmune thrombocytopenia is high in the first newborn of a woman at risk since the involved antigens are fully expressed by foetal platelets; the newborn is at risk for vitamin K deficiency with bleeding due to poor transport of vitamin K across the placenta and low levels of coagulation factors II, VII, IX, X; the diagnosis of some inherited coagulation deficiencies can be difficult in the newborn due to physiologically low levels of coagulation factors; thrombotic events are rare in the healthy neonate, despite physiologically very low levels of several coagulation inhibitors; the pharmacokinetic and effects of antithrombotic agents are influenced by the specificities of haemostasis in neonates. This review will discuss about the foetal development of haemostasis until birth, and some implications regarding the pathophysiology, the diagnosis and the treatment of bleeding disorders in the human neonate. SN - 1769-664X UR - https://www.unboundmedicine.com/medline/citation/20728815/[Specificities_of_neonatal_hemostasis_and_implications_in_pathologic_situations]_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0929-693X(10)70907-6 DB - PRIME DP - Unbound Medicine ER -