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
