Neonatal symptomatic thromboembolism in Germany: Two year survey

Aims-To determine the incidence of neonatal thromboembolism in Germany. Methods-Diagnostic imaging techniques, therapeutic modalities, and short term outcome were evaluated in a prospective nationwide two year case registry study. Results-The reported incidence of symptomatic neonatal thromboembolism, diagnosed in most cases with Doppler ultrasonography, was 5.1 per 100 000 births, with a total of 79 cases registered: renal venous thrombosis (n=35); venous thrombosis (n=25); and arterial vascular occlusion (n=19). Fifty seven of 79 thromboses were associated with additional risk factors (central line n=25, asphyxia n = 13, septicaemia n = 11, dehydration n = 6, maternal diabetes n = 2, cardiac disease n = 1). Inherited thrombophilia was also diagnosed in seven out of 35 cases investigated. Twenty three children received supportive treatment: 42 received heparin and in 13 neonates thrombolytic agents were administered. Most neonates (91%) survived; seven died. Conclusion-controlled multicentre studies are needed to obtain more information on treatment efficacy.