Coagulation dysfunction in a newborn infant caused by maternal exposure to clozapine during pregnancy
10.3760/cma.j.cn114015-20200115-00050
- VernacularTitle:母亲妊娠期氯氮平暴露致新生儿凝血功能障碍
- Author:
Yemin HU
1
;
Liang HUANG
;
Xianrong WEN
;
Hao LUO
Author Information
1. 四川省泸州市妇幼保健院（泸州市第二人民医院）药剂科，泸州 646000
- Publication Type:Journal Article
- Keywords:
Clozapine;
Maternal exposure;
Infant, newborn;
Blood coagulation disorders
- From:
Adverse Drug Reactions Journal
2020;22(11):644-645
- CountryChina
- Language:Chinese
-
Abstract:
A 31-year-old female patient with schizophrenia got pregnant naturally during the treatment with clozapine (50 mg/d) and had been taking the drug during the pregnancy. Prenatal fetal ultrasound and chromosome examination showed no obvious abnormalities. The mother received subcutaneous injections of insulin aspart injection and insulin detemir injection and oral iron polysaccharide complex capsules for gestational diabetes mellitus and mild anemia successively during pregnancy. One live male infant was delivered by cesarean section at 39 +2 weeks of gestation, with a birth weight of 3 280 g. The infant′s Apgar score was 10. Physical examination of the newborn showed scattered ecchymosis on limbs skin, pinpoint-like petechiae on whole-body skin, and arrhythmia by heart auscultation. Laboratory tests showed prothrombin time 14.4 s, activated partial thromboplastin time 69.4 s, thrombin time 22.9 s, fibrinogen 1.27 g/L, and platelet count 366×10 9/L. Neonatal coagulation dysfunction was diagnosed, which was considered to be possibly related to clozapine. Intravenous infusions of vitamin K 1 injection and human fibrinogen were given. Four days later, ecchymosis and petechiae on his whole body were less than before, prothrombin time was 11.4 s, activated partial thromboplastin time was 45.0 s, thrombin time was 20.6 s, and fibrinogen was 2.22 g/L. Eight days later, his ecchymosis and petechiae basically disappeared.
