Abstract
Labratory studies pritor to exchange transfusion in a group of babies with Rhesus isiommunization showed evidence of hemostatic failure in 6 out of 30. Findings in these infants included thrombocytopenia, low plasma fibringen, and abnormalities of the intrinsic coagulation system. five babies had a clinically recognizable bleeding tendency. Fibrin degradation products were found in 11 infants including babies aho had been treated by intra-uterine intraperitoneal transfusion, in addition to those with evidence of hemostatic failure. Eight babies in this group of 03 died, and at necropsy 4 out of 7 had subarachnoid and intracerebral hemorrhage. Three of the 4 had intravascular fibrin thrombi on microscopy of tissue section. An additional postmortem study on babies with Rhesus isoimmunization who died pror to the main investigation revealed massive intracranial hemorrhage associated with the presnce of intravascular fibrin thrombi in 5 cases out of 10. Babies at most risk of hemorrhagic complication are those with a cord Hb below 7 g/100 ml. It is concluded that disseminated intravascular coagulation is a major contributory cause of hemostatic failure in Rhesus isoimmunzation although hepatic dysfunction may play a part in some infants.
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Ghessells, J., Wigci. Esworth, J. 58. Hemostatic failure in Rhesus isoimmunization. Pediatr Res 5, 95 (1971). https://doi.org/10.1203/00006450-197102000-00063
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DOI: https://doi.org/10.1203/00006450-197102000-00063