ULTRASONIC SURVEY OF UMBILICAL ARTERY CAT HETERS IN NEONATES

Background. - Incidence of aortic thromboses in the neonatal period is significantly increased after umbilicar artery catheterization. Popul ation and methods. - Fourty neonates (GA: 34.7 +/- 7.2 wks and birth w eight: 2377 +/- 786 g) were prospectively studied in order to assess f requency and natural history of aortic thromboses due to umbilical art ery catheterization, Investigation was based on serial real-time ultra sonography (2.3 times/week). Presence of aortic thrombus was correlate d with the existence of clinical complications and the results of biol ogical findings (prothrombin and fibrinogen levels; hematocrit) and pl atelet number. Results. - Aortic thrombosis was found in sin patients (15%); it was clinically asymptomatic in two (5%). A vascular wall-fix ed catheter was shown in ten infants (25%); this finding was associate d with thrombosis in five cases and preceded thrombosis in one other. The presence of thrombus and/or abnormal position of the catheter was not corre- lated with gestational age, birth weight, duration of cathe terization, blood hemostasis and results of bacteriological cultures o f the tip of the catheter. Conclusions. - Ultrasonographic control mus t be repeated after umbilical artery catheterization. It permits evalu ation of renal flux and can lead to removal of catheter and/or peculia r therapeutic measures.