Evaluation of Hypercoagulability Using Soluble Fibrin Monomer Complex in Sick Newborns

Abstract

T he function of the hemostatic system is to maintain the balance between the procoagulant and anticoagulant forces through precisely interacting systems and pathways. Disturbance in this balance may lead to bleeding tendency or a hypercoagulable state. The latter state occurs when the procoagulant forces take the upper hand. Many risk factors may contribute to the development of thrombosis either genetic or environmental. Neonates seem to be at high risk to develop thrombosis which might be due to their under developed hemostatic system, stress of delivery or the invasive procedures and risky environment they become prone to after delivery. DIC is one of the most common and fatal complications of neonatal hypercoagulability. Among all the causes of DIC, sepsis is the most prevalent condition causing DIC in neonates. Neonatal sepsis is a syndrome of circulatory compromise caused by invasion of the blood stream by different organisms. Either maternal or fetal factors may lead to development of sepsis; so, the diagnosis rely on combining the history and clinical features with the laboratory and imaging studies. Diagnosis of DIC in neonates is a very difficult issue, and the implementation of any of the developed scoring systems to diagnose DIC in neonates is still limited. Using a combination of laboratory tests, longitudinal assessment of patient's coagulopathy as well as appearance of new diagnostic markers such as SFMC help to make the diagnosis of DIC more possible. In this study we aimed at identifying the presence of a hypercoagulable state in sick newborns by studying the behavior of SFMC with special reference to those of other coagulation tests and evaluating the role of SFMC in early diagnosis of DIC in sick newborns.