Coagulation studies in severe birth asphyxia.

Coagulation studies have been performed in 9 infants who were so severely asphyxiated at birth as to require assisted ventilation for at least 10 minutes. Four of the infants died, though none suffered from any bleeding tendency in life. In 2 fatal cases and 1 survivor the laboratory findings of circulating fibrin degradation products, low plasma fibrinogen, and low or rising platelet count indicated that disseminated intravascular coagulation had occurred in the first few hours of life. Fibrin thromboemboli were found in the liver and adrenals of the 2 such babies that died. One baby had a low level of vitamin K dependent factors associated with fetal growth retardation. Clinical factors common to the cases with evidence of disseminated intravascular coagulation were the need for mechanical ventilation, and the occurrence of hypothermia. Though haemostatic failure due to disseminated intravascular coagulation is likely to develop only in a small minority of birth asphyxiated infants, the possibility should be considered in any that become hypothermic within a few hours of birth.