Haematological Disorders of the Neonate Flashcards
What is Polcythaemia?
excessive RBC levels (>22g/dL) and blood viscosity
What causes polcythaemia?
placental insufficiency
intrauterine hypoxia
What are the clinical signs of polcythaemia?
plethora
cyanosis
What could be prescribed for polcythaemia?
iv fluids
exchange transfusion
What is VKDB?
Vitamin K-Deficiency/Dependent Bleeding
“a haemorrhagic tendency caused by Vitamin K deficiency and decreased activation of Factors II, VII, IX, X, Protein C , and Protein S
What causes VKDB?
Inadequate placental transfer
deficient hepatic stores
limited dietary intake
limited neonatal gut flora to convert Vit K to it’s active form
What are the types of VKDB?
Early - mother on antio-convulsnats/antituvercular meds/ Warfarin
Classic - day 2-6
late-onset - day 14-109 –> intracranial bleeding
What is the presentation of VKDB?
Haematemesis/melaena
oosing puncture sites
diffuse bleeding from umbilical stump
severe jaundice
What is the prevention of VKDB?
Vitamin K prophylaxis (1mg = T baby) (0.5mg PT baby)
What is the treatment of VKDB?
administer Vit K
correct coagulation imbalance
treat anaemia
investigate for long term sequelae of complications –> intrcranial haemorrhage
what does HDN stand for?
Haemolytic Disease of the Newborn
What does DCT stand for?
Direct Coombs Test
What are reticulocytes?
immature RBC
What is Rh factor?
it’s a protein that can be present on the surface of RBC
What is Rh Isoimmunisation?
A condition that happens when a pregnant woman’s blood protein is incompatible with the baby’s, causing her immune system to react and destroy the baby’s blood cells
What are the risk factors of Rh Isoimmunisation?
previous pregnancy
delivery
Aminocentesis, choronic villus sampling; External version (of breech)
manual removal of placenta
placental abruption
ectopic pregnancy
spontaneous/therapeutic abortion
male sex
What Antenatal screenings happen for RhD?
blood group
rh typing
antibody screening
high resolution U/S
What infant screening happen for RhD?
FBC
blood film
group and DCT
What types of Coombes Test are there?
Direct detects antibodies that are bound to the RBCs
Indirect Coombes detects antibodies in the serum
What clinical signs present for RhD?
jaundice
tissue hypoxia
congestive cardiac failure
ascites
petechiae
hypoglycaemia
positive DCT
What prevention is there for RhD?
Anti-D
early phototherapy
How is ABO Incompatibility presented?
Jaundice
anaemia (mild)
How is ABO Incompatibility diagnosed?
blood group and RH typing
DCT
FBC and Retics
Blood film
SBR
