Treatment of Neonatal Arterial Thromboembolism: A Case Report

The incidence of thromboembolic events in the pediatric age group is higher in neonates (1). In a German study the incidence of thromboembolc events in the neonatal period was 5.1 per 100000 births (2) and 2.4 per 1000 NICU admissions with 45% to 55% of these events occurring in preterm infants (3). Risk factors for thromboembolic events are infection, polycythemia, gestational diabetes mellitus of mothers, perinatal asphyxia and inherited thrombophilia such as factor 5 Leiden and deficiency of protein C and S, dehydration and shock, congenital heart disease, umbilical venous and arterial catheters (1, 4). Thromboembolic events in the neonatal period often require urgent intervention to restore perfusion and to prevent morbidity and even mortality. The most common clinical findings are irritability, absent peripheral pulses, pallor or duskiness of extremities, coldness of the lower extremities and difference between the upper and lower extremities’ tensions. Diagnosis of arterial thrombosis is confirmed by ultrasonography. Therapeutic options include anticoagulation, fibrinolytic therapy, surgical thrombectomy or combination of these therapies according to location of thrombosis and clinical finding