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The chief causes of this condition are: syphilis, infection, hypoplasia of the coagulating elements of the blood and asphyxia. External factors, such as parity, the fetal presentation, duration of labor, complications of labor, obstetric operations and chloroform, are of minor importance. Syphilis, according to Holt, is a causative factor in from 2 to 6 per cent. of the cases, contrary to a generally current idea that syphilis is always the cause.
The pathology of this condition is yet rather obscure. In nine personal post mortems, Townsend states that there were no gross lesions except the hemorrhages, and in one case the blood-culture was negative. He also reports eighty-one post mortems from the literature, in most of which no lesions of any sort were found, except hemorrhages. In a few cases the following lesions were present: lesions of syphilis, enlarged spleen, enlarged liver, inflammation of the umbilical and portal veins and
LESPINASSE VD. THE TREATMENT OF HEMORRHAGIC DISEASE OF THE NEW-BORN BY DIRECT TRANSFUSION OF BLOOD. JAMA. 1914;LXII(24):1866-1869. doi:10.1001/jama.1914.02560490012002