A study of Prothrombin Time, Thrombin Time, Fibrinogen and Vitamin K Levels in Sudanese Neonates with Proven Sepsis

Aim: This study aims to assess Prothrombin Time (PT), Thrombin Time (TT), fibrinogen and Vitamin K levels in Sudanese neonates with sepsis. It also aims to correlate those parameters with outcome, sepsis onset, and etiologic agent in the case group. Methods: The study was done in Omdurman maternity hospital from June 2013 to April 2015 on a total of 100 neonates divided equally into case (neonates with proven sepsis) and control (healthy neonates). PT was assessed by measuring the clotting time needed by the plasma after calcified thromboplastin was added, expressed in seconds. TT was also assessed by the clotting procedure after thrombin was added to plasma,
also expressed in seconds. Fibrinogen was assessed using the Clauss method, using 1/20 diluted plasma then counting clotting time after thrombin was added, with results obtained in mg/dl. Vitamin K was assessed using high-performance liquid chromatography (HPLC) after plasma was prepared, extracted, injected into HPLC system, separated using C-18, then reduced by the zinc in the post-column reduction reactor then assessed by fluorescent detector, the result expressed in ng/ml. Results: Among the case group; neonates who died constituted 10 (20%), with 40 recovered (80%). PT was significantly prolonged in septic neonates compared to the healthy ones (p value 0.01). Early sepsis neonates showed significant prolongation in both PT and TT compared to the late onset neonates (p value 0.02 and 0.00). Fibrinogen showed significant increase in septic neonates compared to healthy one (p value 0.00). Vitamin K didn’t show significant decrease in septic neonates compared to the control. None of the outcome, onset of sepsis and etiologic agent of sepsis showed significant correlation with fibrinogen or Vitamin K. Conclusion: In concordance with our findings, sepsis leads to coagulopathy and thus the morbidity and mortality rates could increase among neonates with sepsis. Involvement of coagulation evaluation in sepsis can be beneficial in diagnosis and management of septic cases