[Ultrasonographic survey of the effect of umbilical arterial catheterization in newborn infants].

BACKGROUND

Incidence of aortic thromboses in the neonatal period is significantly increased after umbilicar artery catheterization.

POPULATION AND METHODS

Fourty neonates (GA: 34.7 +/- 7.2 wks and birth weight: 2377 +/- 786 g) were prospectively studied in order to assess frequency and natural history of aortic thromboses due to umbilical artery catheterization. Investigation was based on serial real-time ultrasonography (2.3 times/week). Presence of aortic thrombus was correlated with the existence of clinical complications and the results of biological findings (prothrombin and fibrinogen levels; hematocrit) and platelet number.

RESULTS

Aortic thrombosis was found in six patients (15%); it was clinically asymptomatic in two (5%). A vascular wall-fixed catheter was shown in ten infants (25%); this finding was associated with thrombosis in five cases and preceded thrombosis in one other. The presence of thrombus and/or abnormal position of the catheter was not correlated with gestational age, birth weight, duration of catheterization, blood hemostasis and results of bacteriological cultures of the tip of the catheter.

CONCLUSIONS

Ultrasonographic control must be repeated after umbilical artery catheterization. It permits evaluation of renal flux and can lead to removal of catheter and/or peculiar therapeutic measures.