NEONATAL HEMATOLOGIC CONDITIONS

ERYTHROBLASTOSIS FETALIS :
This is the most hemolytic form of RH hemolytic disease. Excessive destruction of the fetus red
cells leads to severe anemia, tissue anoxaemia and metabolic acidosis. These have got adverse
effects on the fetal heart and brain and placenta. Hyperplasia of the placental tissue occurs in an
effort to increase the transfer of oxygen but the available fetal red cells
is progressively diminished due to haemolysis. As a result of fetal anoximia, there isdamage to th
e liver leading to hypoprotenimia which is responcible for generalized edema, ascites and
hydrothorax. Fetal death occurs sooner or later due to cardiac failure. The baby is either still born
or macerated and even if born alive, dies soon after.

Hemorrhagic disorder in the newborn :

It is the syndrome characterized by spontaneous internal or external bleeding

CAUSES

 Abnormalities in clotting facter Deficiencies in vitamin K dependent factor II, VII,IX,X.

it usually occurs betweenD2 and D5 and common in the preterm and breastfed babies.
 Deficiency of proteinc is also responsible.
 Drugs received during pregnancy – phenytoin, coumarin compounds, salicylates
 DIC: Due to infection, Anorexia, Shock
 Platelet dysfunction
 Inherited abnormalities of blood coagulation: haemophilia, von wille bra
nd’sdisease
 Trauma: obstetric trauma causing cephal hematoma, visceral injury, umblical
cord rupture
 Others: liver dysfunction

DIAGNOSIS

Clinical examination:

CBC, blood smear, platelet count,PT, PTT,INR, bleedingtime and d- dimer

TREATMENT

Vitamin K 1 mg, i.v

Fresh frozen plasma
Platelets concentrates
Fresh whole blood
Treatment of specific problem
MANAGEMENT OF THE CORD BLEEDING
If bleeding occurs following separation of the cord, haemostasis may be achived by pressure or
by a ligature after securing the bleeding points with pair of arteryforceps even a small amount of
blood loss may be lethal and should be replaced by blood transfusion, if necessary