The Prothrombin Time in the Newborn: Effect of Contact Activation^[*]

Summary

The effect of foreign-surface contact on prothrombin conversion in adult plasma is compared to that of the newborn. The tests utilized in this comparison were the one-stage prothrombin time of Quick, the second stage of the thromboplastin generation test, and the prothrombin consumption test or the serum prothrombin time. In all of these there is much less acceleration produced by foreign-surface contact in the plasma of the newborn. Acceleration of the prothrombin conversion time is directly related to an increase in activity of factors VII and XL At no time could an increase in prothrombin activity be demonstrated. The decreased acceleration produced by foreign-surface contact in the plasma of the newborn is due primarily to a decreased level of factor VII as well as those factors necessary for its activation.

^* Presented in part at the 10th Congress of the European Society of Hematology, Strasbourg, August 23-28, 1965.

• References

• 1 Abolii A. J, Lamerens S. Coagulation changes in the neonatal period and in early infancy. Ped. Clin. N. A 9: 785 1962;
• 2 Alexander B, Landwehr G. Evolution of a prothrombin conversion accelerator in stored human plasma and prothrombin fractions. Amer. J. Physiol 159: 322 1949;
• 3 Bachman F, Duckert F, Koller F. The Stuart-Prower factor assay and its clinical significance. Thrombos. Diathes. haemorrh. (Stuttg.) 2: 24 1958;
• 4 Hjort P. J. Intermediate reactions in the coagulation of blood with tissue thromboplastin. Scand. J. clin. Lab. Invest. 9 Suppl. 27 1957
• 5 Johnston Jr. C. L, Ferguson J. H, O’Hanlon F. A. Surface activation of plasma clotting; a function of Hageman factor. Proc. Soc. exp. Niol. (N. Y.) 99: 197 1958;
• 6 Kappeler R. Das Verhalten von Faktor V im Serum unter normalen und pathologischen Bedingungen. Z. klin. Med 153: 103 1955;
• 7 Koller F, Loeliger A, Duckert F. Experiments on a new clotting factor. Factor VII. Acta haemat. (Basel) 6: 1 1951;
• 8 Künzer W. Zur Physiologie der Blutgerinnung bei Neugeborenen. Dtsch. med. Wschr 89: 1005-1077 1964;
• 9 Kurkcuoglu M, McElfresh A. E. The Hageman factor: determinations of its concentration during the neonatal period and presentation of a case of Hageman factor deficiency. J. Pediat 57: 61 1960;
• 10 Nossel H. L, Niemetz J. Celite eluate test for assaying factor XI (PTA). Fed. Proc 24: 452 1965;
• 11 Quick A. J. The nature of the bleeding in jaundice. J. A. M. A 110-1658 1938;
• 12 Quick A. J, Stefanini M. The state of component A (prothrombin) in human blood; evidence that it is partly free and partly in an inactive or precursor form. J. Lab. clin. Med 34: 1203 1949;
• 13 Quick A. J. The physiology and pathology of hemostasis. Lea and Febiger; Philadelphia: 1951
• 14 Quick A. J. Hemorrhage in the newborn. Lancet 85: 222 1965;
• 15 Rapaport S. I, Aas K, Owren P. A. The effect of glass upon the activity of the various plasma clotting factors. J. clin. Invest 34: 9 1955;
• 16 Shanberge J. N, Matsuoka T. Studies regarding the effect of foreign-surface contact on the one-stage prothrombin time determination. Thrombos. Diathes. haemorrh. (Stuttg.) 15: 442 1966;
• 17 Soulier J.-P, Prou-Wartelle O. New data on Hageman factor and plasma thromboplastin antecedent : The role of contact in the initial phase of blood coagulation. Brit. J. Haemat 6: 88 1960;
• 18 Waaler B. A. Contact activation in the intrinsic blood clotting system. Scand. J. Clin. Invest. 11, Suppl.37 1959