Coagulation profiles in neonates--if the specimen clots repeat the test.

OBJECTIVE The aims of this study were to determine in two institutions the frequency of clotted coagulation profile specimens in neonatal patients, the proportion of patients who had the test repeated if the coagulation profile specimen clotted and the number of abnormal results in the tests that were repeated. METHODS The number of neonatal coagulation profiles (i.e. prothrombin time and activated partial thromboplastin time) were identified from the pathology databases at the Royal Women's Hospital and at the Mater Mother's Hospital. Each specimen that clotted and the number of tests that were repeated were identified and counted. Data from the tests that were repeated were analysed and compared with normal ranges for neonates. RESULTS There were 746 specimens that were sent for a coagulation profile of which 45 (6.0%) clotted. Of the 45 clotted specimens, 31 (69%) were repeated. From the 31 repeated specimens, 6 clotted, 1 was an 'insufficient' specimen, and 24 were able to be processed. From the 24 processed specimens 17 (71%) had an abnormal result, 11 of which had a mildly elevated prothrombin time and the other six had a severe clotting abnormality. CONCLUSIONS If a neonatal patient's coagulation profile specimen clots it should not be assumed that the infant's clotting is normal, and another specimen should be sent for analysis.