5 days ago · Neonatal sepsis. In common clinical usage, neonatal sepsis refers to a bacterial blood stream infection in the first month of life, such as meningitis, pneumonia, pyelonephritis, or gastroenteritis, but neonatal sepsis also may be due to infection with fungi, viruses, or parasites.
5 days ago · Preterm birth, also known as premature birth, is the birth of a baby at fewer than 37 weeks gestational age, as opposed to full-term delivery at approximately 40 weeks. Very early preterm birth is before 32 weeks, early preterm birth occurs between 32–36 weeks, late preterm birth is between 34–36 weeks' gestation.
5 days ago · 500,000 maternal deaths a year. Childbirth, also known as labour or delivery, is the ending of pregnancy where one or more babies leaves the uterus by passing through the vagina or by Caesarean section. In 2015, there were about 135 million births globally. About 15 million were born before 37 weeks of gestation, while between 3 and 12% were ...
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5 days ago · Meningitis is an acute inflammation of the protective membranes covering the brain and spinal cord, known collectively as the meninges. The most common symptoms are fever, headache, and neck stiffness. Other symptoms include confusion or altered consciousness, vomiting, and an inability to tolerate light or loud noises.
5 days ago · floresianus. Jentink, 1905. natunensis. Miller, 1901. nicobaricus. Miller, 1902. Boar growls. The wild boar ( Sus scrofa ), also known as the wild swine, common wild pig, Eurasian wild pig, or simply wild pig, is a suid native to much of Eurasia and North Africa, and has been introduced to the Americas and Oceania.
- Table 1. Classification of Neonatal Thrombocytopenia
- Immune-Mediated Thrombocytopenia
- Infection-Mediated Neonatal Thrombocytopenia
- Genetic Neonatal Thrombocytopenia
- Drug-Related Thrombocytopenia
- Miscellaneous Causes of Neonatal Thrombocytopenia
The major mechanism underlying neonatal thrombocytopenia, accounting for about 75% of cases, is impaired platelet production.Increased platelet consumption and/or sequestration are the chief mechanisms in the remainder of cases. In some neonates, a combination of mechanisms (reduced platelet production and accelerated destruction) is responsible for the low platelet count. Laboratory evaluations can provide clues to the kinetic mechanism of an infant's thrombocytopenia. Mean platelet volume (MPV) is a measure of the average size of circulating platelets. MPV is normal (7.5-9.5 fL) when thrombocytopenia is caused by reduced production, and elevated (> 10-12 fL) when caused by accelerated destruction. Larger platelets are evident when the bone marrow is stimulated to produce more immature platelets in response to increased platelet utilization. MPV is measured by automated analyzers and is reported along with the platelet count or can be obtained by calling the laboratory. The percent...
Neonatal Alloimmune Thrombocytopenia.Neonatal alloimmune thrombocytopenia is a condition that affects 1 in 2000 live births. These otherwise healthy newborns present with petechiae and low platelet counts. The pathogenesis of neonatal alloimmune thrombocytopenia is analogous to Rh hemolytic disease of the newborn. Mothers of affected infants have normal platelet counts. The fetus carries an antigen (usually the HPA-1a) that is foreign to maternal platelets and sensitizes the mother. Transplacental antibodies produced by the mother in the second trimester destroy fetal platelets, resulting in thrombocytopenia. Unlike Rh disease, a first pregnancy can be affected. Intracranial hemorrhage, which can occur prior to birth, is found in about 10% to 15% of affected neonates. Neonatal Autoimmune Thrombocytopenia.In autoimmune thrombocytopenia, the mother has idiopathic thrombocytopenia or systemic lupus erythematosus and is thrombocytopenic. Maternal antiplatelet antibodies cross the placen...
More than 80% of neonates with proven infections become thrombocytopenic. Bacterial, fungal, and viral infections have all been associated with neonatal thrombocytopenia. Bacterial Infections.Bacterial infection causes endothelial damage, thus accelerating destruction of platelets and their removal by the reticuloendothelial system. At the time bacterial infection is diagnosed, 25% of neonates will already have low platelet counts. By 36-48 hours later, virtually all will be thrombocytopenic. It is commonly believed that thrombocytopenia associated with bacterial infection is caused by disseminated intravascular coagulation (DIC), but DIC is actually present in a minority of cases. The average duration of bacterial infection-mediated thrombocytopenia is 6 days. Fungal Infections. The majority (75%) of neonates with fungal infection are thrombocytopenic at the time of diagnosis. Thrombocytopenia may be the most important clinical finding in neonates with Candidasepsis. Viral Infectio...
A dysmorphic neonate with mild to moderate thrombocytopenia (50,000-150,000/mcL) most likely has a genetic syndrome associated with thrombocytopenia, such as trisomy 13, 18, 21, triploidy, or Turner's, Noonan's, Alport, or Wiskott-Aldrich syndromes. Some metabolic disorders, such as the organic acidemias isovaleric and methylmalonic acidemia, are also associated with neonatal thrombocytopenia. Thrombocytopenic absent radius syndrome (TARS) is an autosomal recessive disorder in which radii are absent bilaterally but thumbs are present. Forearms are foreshortened and bowed. Thrombocytopenia is severe, and a third of babies also have congenital heart disease. Platelet counts of infants with TARS gradually decrease over the first year of life, resulting in early death from bleeding at 1 or 2 years of age. Congenital amegakaryocytic thrombocytopenia is caused by a defect in the Tpo receptor. Severe thrombocytopenia with eventual pancytopenia usually leads to death from hemorrhage.
Few drugs have been proven to cause neonatal thrombocytopenia. Quinine taken during pregnancy is associated with maternal and neonatal thrombocytopenia. Heparin can cause thrombocytopenia in about 10% of adults, but this is probably rare in neonates.
Thrombocytopenia is common and often severe in infants with necrotizing enterocolitis (NEC). Platelet destruction occurs in the endothelium of vessels that supply blood to areas of bowel in the early stages of necrosis. Thrombocytopenia is also associated with intrauterine growth restriction and infants who are small for gestational age; the pathogenic mechanism is low platelet production. Birth asphyxia is also associated with thrombocytopenia, although hypoxia alone does not appear to be sufficient to decrease platelets. Infants born of mothers with pregnancy-induced hypertension are often thrombocytopenic, but it is not severe or prolonged. Severe and prolonged thrombocytopenia can occur, however, as a result of thrombus formation along an intravascular catheter, in the renal vein, right atrium, or sagital sinus. Platelets adhere to the propagating clot, resulting in low circulating platelet count.