Secondary haemorrhagic disease of the newborn.

Clinical, laboratory, and necropsy findings are presented in 5 newborn infants who died with a haemorrhagic diathesis developing within 24 hours after birth. 4 babies were born prematurely; 3 suffered birth asphyxia; and 3 became hypothermic. Laboratory studies showed fibrin degradation products, low platelet counts, and deficient coagulation factors. At necropsy extensive subarachnoid haemorrhages of a characteristic type were seen in all cases, and intravascular fibrin deposits in all but one. Haemorrhage in these babies is considered to be due to consumption of platelets and coagulation factors as a consequence of disseminated intravascular coagulation. Predisposing conditions and possible pathogenic mechanisms are discussed. Platelet counts aid early diagnosis of this form of haemorrhagic disease. Treatment by exchange transfusion using fresh heparinized blood is suggested.