Disseminated Intravascular Coagulation in Newborn

Disseminated Intravascular Coagulation in Newborn

Disseminated intravascular coagulation (DIC) is a condition that affects the way blood clots in the body.

DIC is a medical emergency. Without treatment, the condition can damage tissues in the body and lead to severe bleeding and organ failure.

DIC happens when proteins that help form blood clots become overactive and form small blood clots all over the body.

These clots may clog up blood vessels and cut off the blood supply to important organs, such as the liver, brain, or kidneys. DIC causes low levels of:

• Blood cells that carry oxygen (red blood cells).
• Blood cells that help clotting(platelets).
• Chemicals in the body that help form clots(clotting factors).
• Chemicals made by the body to break down and prevent clotting (anticoagulant proteins).

What are the causes?

This condition may be caused by any serious disease or problem, including:

• A problem caused by high blood pressure (hypertension) during the pregnancy, such as maternal toxemia and preeclampsia.
• Separation of the placenta before delivery (placental abruption).
• Severe lung disease due to premature birth (respiratory distress syndrome).
• A severe, widespread infection (sepsis).
• Severely low levels of red blood cells (anemia).
• Death of a twin in the womb.
• A transfusion reaction.
• Blood incompatibility between the mother and baby.
• Liver disease.
• Intestinal inflammation and infection (necrotizing enterocolitis).
• Birth defects that stop the body from making certain proteins.
• Problems caused by heart or lung disease during pregnancy.
• Respiratory problems, such as acute respiratory distress syndrome (ARDS) or aspiration of amniotic fluid.
• A tumor.

What are the signs or symptoms?

Symptoms of this condition include:

• Bruising.
• Unusual bleeding from areas where blood was drawn for testing or where IVs are placed (skin puncture sites).
• Leaking of blood from the umbilical cord, nose, or mouth.
• Pale or blue skin.
• Blood in urine or stools.
• Trouble breathing.
• Low blood pressure (hypotension).

How is this diagnosed?

This condition is diagnosed by testing blood for:

• White blood cell counts.
• Red blood cell counts.
• Platelet counts.
• Clotting times and clotting factors.
• Products of clot breakdown.
• Signs of organ damage or failure.
• Measurements of lung function.

How is this treated?

Your baby will be treated in the intensive care unit, where he or she will be monitored closely. Treatment will involve identifying and treating the cause of DIC. It will also involve supporting normal blood clotting, such as with:

• Blood transfusions to treat anemia and hypotension.
• Transfusions of platelets.
• Transfusions of the liquid portion of blood (plasma) to replace clotting factors and anticoagulant proteins.
• Transfusions of the clotting factors Factor VII-a or cryoprecipitate.
• Medicines to prevent clotting (anticoagulants orblood thinners).
• Oxygen to treat breathing problems. This may involve using a breathing machine (ventilator).
• IV fluids and medicines to treat hypotension and to give fluids if your newborn cannot drink.
• Antibiotic medicines to treat infections.

Follow these instructions at home:

• Give your child over-the-counter and prescription medicines only as told by the health care provider.
• If your child was prescribed an antibiotic medicine, give it to your child as told by the health care provider. Do not stop giving the antibiotic even if your child seems to be getting better.
• Keep all follow-up visits as told by your child’s health care provider. This is important.

Contact a health care provider if:

• Your child is not feeding well.
• Your child seems less active than normal.

Get help right away if:

• Your child who is younger than 3 months has a temperature of 100°F (38°C) or higher.
• Your child who is older than 3 months has a fever and persistent symptoms.
• Your child who is older than 3 months has a fever and symptoms suddenly get worse.
• Your child has unusual bruising.
• Your child has bleeding that does not stop.
• Your child has trouble breathing. Watch for:
  • Rapid breathing.
  • A grunting sound when breathing out.
  • The spaces between and under the ribs sucking in when your child breathes in.
  • Flaring of the nostrils.
  • A blue color around the lips.

Summary

• Disseminated intravascular coagulation (DIC) is a condition that affects the way blood clots in your child’s body.
• Bleeding and organ failure is a serious complication of DIC.
• The treatment for DIC in newborns is to support normal blood clotting and to treat the underlying cause.