L11: Neonatal Anemia

Question 1

Hb Level in Newborn

Answer 1

• 16 - 18 gm/dI

Due to stimulation of B.M. by relative intra-uterine hypoxia

Question 2

Hb Level in old infants & Children

Answer 2

• 10 - 12 gm/dl

But this level represent anemia at birth

Question 3

Physiological Anemia in Infancy

Answer 3

Question 4

Physiological Anemia in Infancy

• In Utero

Answer 4

Question 5

Physiological Anemia in Infancy

• After Birth

Answer 5

Question 6

Anemia of Prematurity

Answer 6

Question 7

Anemia of Prematurity

• Early

Answer 7

Hb nadir is lower (8-10 g/dl) & is reached earlier than term infant (5 - 10 weeks).

Question 8

Anemia of Prematurity

• Late

Answer 8

Question 9

• Iron administration before the age of 2 months …….
• However, this iron is stored for later use to prevent late anemia

Answer 9

doesn’t prevent early anemia of newborn

Question 10

Causes of Anemia of Newborn

Answer 10

Question 11

Causes of Anemia of Newborn

• Blood Loss

Answer 11

Question 12

Causes of Anemia of Newborn

• Obsteric Blood Loss

Answer 12

• Abruption placenta & placenta previa.
• Incision of placenta iní C.S
• Rupture of the cord

Question 13

Causes of Anemia of Newborn

• Occult Blood Loss

Answer 13

Question 14

Causes of Anemia of Newborn

• Bleeding in Neonatal Period

Answer 14

Question 15

Causes of Anemia of Newborn

• Hemolysis

Answer 15

Question 16

Causes of Anemia of Newborn

• Immune Hemolysis

Answer 16

• Rh, ABO, or minor group incompatibility.
• Drug-induced hemolytic anemia (e.g., penicillin).

Question 17

Causes of Anemia of Newborn

• Non-Immune Hemolysis

Answer 17

• Congenital or acquired infection.
• Vitamin E deficiency.
• RBC membrane disorders (e.g., hereditary spherocytosis).
• RBC enzyme deficiencies (e.g., G6PD deficiency)
• Acquired (e.g., DIC).

Question 18

Causes of Anemia of Newborn

• Decreased RBCs Production

Answer 18

Question 19

INVx for Anemia of Newborn

Answer 19

Question 20

INVx for Anemia of Newborn

• Initial Labs

Answer 20

• CBC with RBC indices
• Peripheral blood smear
• Reticulocytic count
• Serum bilirubin

Question 21

INVx for Anemia of Newborn

• Specific Tests

Answer 21

Question 22

TTT of Anemia of Newborn

Answer 22

Question 23

TTT of Anemia of Newborn

• Blood transfusion or packed RBCs

Answer 23

10-20 ml/kg

Question 24

TTT of Anemia of Newborn

• Erythrocyte transfusion

Answer 24

Question 25

Erythrocyte transfusion

• In cases with respiratory distress:

Answer 25

• Hematocrit < 35-40%

and/or

• Clinical evidence of hypovolemia (pallor, tachypnea, hypotension, poor perfusion)

Question 26

Erythrocyte transfusion

• In cases without respiratory distress:

Answer 26

• Hematocrit < 25-30%

Question 27

Iron Therapy

Answer 27