Neonatal thromboembolism

Faculty Medicine Year: 1112008
Type of Publication: Theses Pages: 99
BibID 10299237
Keywords : Neonatal thromboembolism    
This systematic review will consider the epidemiology, diagnostic strategies, and outcome for both arterial and venous TE in neonates.And also this study will discusse congenital and acquired prothrombotic risk factors, diagnostic tests, long-term outcomes, and antithrombotic therapy for the management of thromboembolic diseases in newbornsThrombosis risk is multifactorial, with interaction of hereditary risk factors and acquired environmental and clinical conditions. The common causes of neonatal thrombophilia are :antithrombin III , protein C, protein S deficiency, factor V Leiden, and the prothrombin G20210A mutation which are not unusually anticoagulant resistant.The risk of thrombosis in the pediatric population is less than that in adults. However, thromboembolic disease represents a significant source of mortality and morbidity, and venous thromboembolism continues to present a challenge to clinicians. It is important to note that there are various settings such as surgery, flights etc. that can lead to thrombosis in otherwise healthy individuals who have thrombophilic defects. In recent years, there have been major advances in our understanding of congenital defects that predispose to thrombosis. This has led to a more complete understanding of the disease processes, as well as recommendations for appropriate screening, detection, diagnosis and treatment.Current treatment for thrombophilias involves both prophylaxis with low-molecular-weight heparin and treatment involving heparin, warfarin or purified factor concentrate. The presence of an inherited thrombophilia should not alter the intensity of anticoagulant therapy, given that antithrombin, protein C, or protein S deficiency, factor V Leiden, and the prothrombin G20210A mutation are not unusually anticoagulant resistant. However, they can increase the optimal treatment duration after a first thromboembolic event.Clinical trials on treatment are essential since they will provide physicians with the information to determine whether or how they should modify their clinical practice. Correctly identifying hereditary risk factors, together with appropriate genetic evaluation and counseling, will allow the informed patient and physician to work together for effective management of thrombophilia and prevention of subsequent thrombotic events.