Disseminated Intravascular Coagulation Complicating The Perinatal “Dropped-Dead” Syndrome: Lack Of Influence Of Cardio-PulmoNary Resuscitation

A diagnosis of perinatal “dropped-dead” syndrome (PDDS)- defined as an Apgar score of 0 or 1 at one minute after birth - was made on 301/4800 (6%) babies admitted to a neonatal intensive care unit during the period 1973-1980. This disorder may be complicated by clinical features of d is seminated intravascular coagulation (DIC). Laboratory in vestigation of hemostasis was undertaken on 174/301. DIC was defined as a plasma fibrinogen concentration of ⋜150mg per dl. or a 2 unit thrombin time of ⋝ 30 seconds. A retro spective analysis was undertaken in order to determine (a) whether the occurrence of DIC was influenced by the outcome of cardiopulmonary resuscitation (CPR), as reflected in the Apgar score at 5 minutes after birth, and (b) if the features of DIC were transient or persistent. A diagnosis of DIC was made in 69/174 (41%) and it was unrelated to the interval between birth (B) and the time of investigation (I): p = 0.2687. Furthermore, DIC was unrelated to change in the Apgar score (between estimates at one and 5 minutes):t p = 0.3260. Moreover, the change in Apgar score was unrelated to either gestational age (GA): p = 0.0788, or birth weight (BW): p = 0.4776, although the BI interval was related directly to both GA: p = 0.0137 and BW: p = 0.0052. Thus, the outcome of CPR is unrelated to degree of prematurity; but the more premature the baby the sooner he/she is studied after birth. DIC is a common complication of PDDS. It is evident even many hours after birth and is not influenced by the outcome of CPR. The efficacy of alternative therapeutic strategies remains to be evaluated