Impact of Recombinant Tissue Plasminogen Activator Therapy (rtPA) on The Short Term Outcome of Neonatal Thrombosis-A Retrospective Study
Journal Title: Indian Journal of Neonatal Medicine and Research - Year 2018, Vol 6, Issue 4
Abstract
ABSTRACT Introduction: The incidence of clinically apparent neonatal thrombus varies from 5.1 per 1 lakh live births to 2.4 per thousand newborns admitted to neonatal intensive care unit. Well established protocols for the use of fibrinolytic agents like Recombinant Tissue Plasminogen Activator (rtPA) are present for adults, but the same cannot be said for neonates. Aim: To study the effectiveness of rtPA therapy in the treatment of neonatal thrombosis in our centre. Materials and Methods: A retrospective study of neonates diagnosed to have venous, atrial or arterial thrombosis was done for a period of seven years using G HEALTH data base systems. All neonates were treated with rtPA. A total of three doses were given 24 hours apart for the next 72 hours; followed by Enoxaparin, given for three months subcutaneously. Repeat scan was done at 72 hours, before discharge, after one month and three months after starting treatment. Treatment outcome was defined as partial or complete thrombus resolution or no change following treatment. Statistical analysis using SPSS 17.0 analysed median and interquartile range of the data. Results: Eight patients were diagnosed with neonatal thrombosis. Complete thrombosis resolution was documented in six patients while partial thrombus resolution was found in two cases. The median follow up was 13 months. Conclusion: Treatment for neonatal thrombus remains controversial and no set protocols has been established in management of neonatal thrombus. There is very little experience with fibrinolytic treatment in neonatal period.
Authors and Affiliations
Prem Alva, Aswathy Rajan, Ashvij Shriyan, Shwetha Uppaluri
Keywords
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- EP ID EP525788
- DOI 10.7860/IJNMR/2017/37818.2240
- Views 126
- Downloads 0
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