A Family with sever Thrombocytopenia

Introduction:Fetal and neonatal thrombocytopenia due to maternal anti-platelet autoantibodies is a complication of autoimmune thrombocytopenia purpura (AITP) in pregnancy. Usually it is anticipated that infant platelet (PLT) count normalizes within 2 months.Case 1:A newborn male baby ,38+6 wk ,was born by caesarian section in 1/1/2015 .He was admitted in NICU due to disseminated petechial and coffee ground gastric secretion and platelet (PLT) count 14000. The mother was a known case of AITP and splenectomy was done few years ago. PLT transfusion was done before delivery due to PLT count 5000. Other laboratory data for the baby were normal and there was not found any cause for thrombocytopenia. The baby received prednisolone regardless of 5 times IVIG for low PLT count and he was discharged on 41 days old.Case 2:A newborn Female baby, 38+4 wk. sibling of previous case was born in 29/10/2017 and admitted in NICU due to low birth weight (1400 gr) and respiratory distress. PLT transfusion was done for mother before delivery due to PLT count 8900 regardless of steroid Therapy in pregnancy. As the previous case, there was not any abnormal lab test except low PLT count (19000). Prednisolone was started for the baby due to persistent PLT count <20000 regardless of receiving 3 doses of IVIG and she was discharged on 43 days old with normal PLT.Conclusion:Corticosteroid therapy is a effective treatment of thrombocytopenic neonate due to sever maternal AITP.The major reason of exchange transfusion in term and preterm neonateFatemeh Bagheri1, AmirHasan Abedi*21. Neonatal Intensive Care, the faculty member of Azad University, Mashhad, I.R.Iran2. Corresponding Author: nursing student of Azad University, Mashhad, I.R.IranAbstractBackground: Hyperbilirubinemia is the most common cause of neonatal re‐admission. Exchange transfusion is one of the treatments for hyperbilirubinemia in neonates. Understanding the cause of blood transfusion in infants helps to identify neonates at a higher risk of exchange transfusion and prevent them. Therefore, the present study was conducted to investigate the cause of blood exchange in neonates.Method: This review article is based on the study of books and article available on valid site such as pubmed, science direct, irandoc and Sid.Result: factors causing severe hyperbilirubinemia and followed by the need for blood exchange are divided into the several categories:A) Hemolytic factors: ABO incompatibility, Rh incompatibility, G6PD deficiency, Sepsis.B) Non Hemolytic factors: Breast feeding jaundice, prematurity.C) Idiopathic factors include: pathological weight loss that can cause severe hyperbilirubinemia.Conclusion: according to the finding of this article it can be said that, ABO and RH incompatibility, lack of G6PD enzyme, premature infants, inappropriate breast feeding is the cause of hyperbilirubenmia and subsequent blood exchange.The most common cause of severe hyperbilirubenmia is ABO incompatibility. Method that can be made to prevent this factor include:. prevention of premature labor.educatind successful and appropriate breastfeeding for mothers.neonatal screening to prevent the incompatibility of blood group and prevent problem cause by lack of G6PD enzyme. At the end, the frequent visits of infants and attention to other risk factors especially in first 4 day after birth.

کلیدواژه ها:

Severe hyperbilirubinemia ، Neonatal jaundice ، Exchange transfusion