Two Unusual Cases of Spontaneous Thrombosis in Neonates: Management and Outcome

Neonatal thrombosis usually occur as a complication of an indwelling central vascular catheter. Here we report two unusual cases of spontaneous thrombosis in neonates. In case 1, baby had a left atrial thrombus diagnosed soon after birth serendipitously by echocardiography. Since the thrombus was highly mobile with risk of embolization, he was given thrombolytic therapy. Thrombolysis resulted in prompt resolution of the thrombus without any complication. In case 2, baby had a chronic left axillary artery thrombosis that had occurred in utero. He presented at birth with features of limb ischemia. He was given anticoagulant therapy for three months. Though the limb perfusion and movements normalized, he developed shortening of the limb due to chronic ischemia. To conclude, due to non-availability of standard guidelines and scarcity of existing literature, management of these neonates is arbitrary. Owing to the rapidly expanding neonatal intensive care that contemplates more such cases, it is time to formulate separate guidelines for the management of thrombosis in neonates.