Outcome of neonatal thrombocytopenia in tertiary care NICU

2020 ◽  
Vol 10 (3) ◽  
pp. 92-96
Author(s):  
Deepak Madhavi ◽  
Shamama Subuhi ◽  
Mohammed Zubai

Thrombocytopenia is one of the commonest haematological disorders in the neonatal period, affecting up to a third of those admitted to neonatal intensive care units. It is well recognized that many fetomaternal and neonatal conditions are associated with thrombocytopenia. The majority of episodes of neonatal thrombocytopenia are relatively mild, self-limiting and of short duration but it may cause severe morbidity & mortality due to severe complication like IVH. Methods & material: 140 Newborn admitted in tertiary care NICU were selected to find out outcome and etiology of neonatal thrombocytopenia. Detail maternal history and neonatal physical examination done and Neonates were followed for outcome, relevant investigation done according to cases. Result: Out of 140 neonates 63 neonates had thrombocytopenia (45%).42.8% neonates were premature out of which 63.3% had thrombocytopenia. Other neonatal risk factor for thrombocytopenia are sepsis 38 (74.5%), SGA/IUGR 28(80%) and NEC 9(100%). Maternal risk factor for thrombocytopenia are eclampsia81.8% and infection during pregnancy 72.72%. 95.5 % of all study population were discharged.4.5 % cases of whole study population didn’t survive. 4.54% of mild, 9.09% of moderate and 60 % of severe thrombocytopenic babies didn’t survive. Conclusion: Bleeding manifestations i.e. mucosal, cutaneous and intracranial bleed were significantly associated with severe thrombocytopenia. 60% of mortality was found in severe thrombocytopenic group. Thus, severe thrombocytopenia was found to be a predictor of poor outcome in sick neonates of NICU.

2019 ◽  
Vol 6 (3) ◽  
pp. 1344
Author(s):  
Sumarth Lal Meena ◽  
Kanwar Singh ◽  
Sanjiv Jain ◽  
Anil Jain ◽  
B. S. Karnawat

Background: Thrombocytopenia (platelet count <1,50,000/µL) is one of the most common haematological problems in neonatal intensive care units. In contrast, only 2% of the normal neonates are thrombocytopenic at birth with severe thrombocytopenia (platelet count <50,000/µL) occurring in less than 3/1000 term infants. Multiple disease processes can cause thrombocytopenia in neonates. The important causes of thrombocytopenia in neonates are sepsis, birth asphyxia, prematurity, intra-uterine growth retardation, hyperbilirubinemia, respiratory distress syndrome, meconium aspiration syndrome and low birth weight. Apart from platelet count, bleeding manifestations depend on underlying ailments. The aims and objective were to study the clinical profile, etiology and outcome of neonatal thrombocytopenia in a tertiary care hospital.Methods: Prospective study involving 100 neonates with or developed neonatal thrombocytopenia in NICU.Results: In present study, 100 new-borns with thrombocytopenia 46% were mild, 35% were moderate and 19% were severe thrombocytopenia. 51 (51%) had early onset neonatal thrombocytopenia and 49 (49%) babies had late onset neonatal thrombocytopenia. Anaemia was the dominant maternal predisposing risk factor. Sepsis was the most common cause of neonatal thrombocytopenia. Most common symptom was apnoea. Sepsis, RDS and NEC had significantly contributed to mortality. Most common cause of death was sepsis followed by RDS and NEC.Conclusions: Neonatal thrombocytopenia is a treatable and reversible condition. Hence, it is important to identify neonates at risk and initiate transfusion therapy to prevent severe bleeding and potentially significant morbidity. Anaemia and PROM were the commonest maternal risk factors. Therefore, author recommended that babies born to mothers with these risk factors should be closely monitored for thrombocytopenia.


2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Xin Li ◽  
Ying Li ◽  
Min Lei ◽  
Jing Tian ◽  
Zuocheng Yang ◽  
...  

Abstract Background Neonatal thrombocytopenia is common in preterm and term neonates admitted to neonatal intensive care units. The etiology behind neonatal thrombocytopenia is complex. Inherited thrombocytopenia is rare and usually results from genetic mutations. Case presentation Here we report a case of twins with severe inherited thrombocytopenia presented in the neonatal period who were shown to be compound heterozygotes for 2 UDP-N-acetylglucosamine 2-epimerase (GNE) gene mutations, c.1351C > T and c.1330G > T, of which c.1330G > T is a novel mutation. Conclusion These two GNE mutations may help in the diagnosis and management of thrombocytopenia diagnosed in neonates.


2018 ◽  
Vol 14 (2) ◽  
pp. 65-68
Author(s):  
Bishow Bandhu Bagale ◽  
Anita Bhandari

ABSTRACTBackground: Thrombocytopenia is a frequently encountered hematological abnormality in Neonatal Intensive Care Unit (NICU). There are various maternal and neonatal risk factors associated and the incidence varies greatly depending upon the population studies. This study was performed on neonates admitted in Bharatpur Hospital NICU.Materials & Methods: In this retrospective study, 412 neonates who were admitted in NICU from November 2016 to October 2017 were included in the study. Frequency of thrombocytopenia was determined along with associated maternal and neonatal risk factors. Maternal risk factors like Pregnancy induced hypertension (PIH), Diabetes, Eclampsia, drug use and neonatal risk factors like sepsis, asphyxia, intrauterine growth retardation (IUGR), prematurity were analyzed. Requirement of platelet transfusion and the outcome were also evaluated. Results: Of the 412 neonates included, 74 had thrombocytopenia which comprised approximately 18% neonates admitted in NICU. Early onset thrombocytopenia occurring within 72 hrs comprised 91.8% while late onset thrombocytopenia occurring after 72 hrs comprised 8.2% of total thrombocytopenia. 58.1% (43) were mild , 29.7% (22) moderate and 12.2% (9) severe thrombocytopenia. The major neonatal risk factors were sepsis, asphyxia, IUGR and prematurity while gestational diabetes and PIH were maternal risk factors contributing to neonatal thrombocytopenia. Only 4.05% received platelet transfusion. 77.03% of the neonates recovered and were discharged while 12.16% neonates were referred to other centres and 5.40% neonates died.Conclusion: Neonatal thrombocytopenia accounted for 18% of neonates which were admitted in the NICU. Significant neonatal risk factors were asphyxia and sepsis and maternal risk factors were PIH and diabetes. Majority did not require platelet transfusion and outcome was also good.


2020 ◽  
Vol 20 (2) ◽  
pp. 535-544
Author(s):  
Raquel Gomes Lima ◽  
Verônica Cheles Vieira ◽  
Danielle Souto de Medeiros

Abstract Objectives: to assess preterm infants’ characteristics, health conditions and neonatal care effect on their death at the neonatal ICU. Methods: this was a non-concurrent cohort study, including preterm infants from three neonatal ICUs from January 1st to December 31st, 2016, followed during the neonatal period and deaths registered during the entire hospitalization. Multivariate analysis was performed using Poisson regression. Results: of the 181 preterm infants, 18.8% died during hospitalization. Associated with the outcome: a gestational age between 28 and 32 weeks (RR= 5.66; CI95%= 2.08-15.40), and less than 28 weeks (RR=9.24; CI95%=3.27-26.12), Apgar score of 5th minutes less than 7 (RR: 1.82; CI95%=1.08-3.08), use of invasive mechanical ventilation up to 3 days (RR= 4.44; CI95%= 1.66-11.87) and 4 days and more (RR=6.87; CI95%=2.58-18.27). Besides the late sepsis (RR: 3.72, CI95%=1.77-7.83), acute respiratory distress syndrome (RR=2.86, CI95%=1.49-5.46), pulmonary hemorrhage (RR=1.97; CI95%=1.40-2.77), and necrotizing enterocolitis (RR= 3.41; CI95%=1.70-6.83). Conclusions: the results suggest the importance of using strategies to improve care during childbirth, conditions for extremely premature infants, early weaning from a mechanical ventilation and prevention on nosocomial infection.


2007 ◽  
Vol 26 (2) ◽  
pp. 97-102 ◽  
Author(s):  
Lina Kurdahi Badr ◽  
Bahia Abdallah ◽  
Sossi Balian ◽  
Hala Tamim ◽  
Mirvat Hawari

Purpose:The purpose of this study was to investigate the relationship between the time of birth and the mortality and morbidity of infants admitted to neonatal intensive care units.Design:This prospective, cohort study examined the records of women and infants admitted to the NICUs of four hospitals in Beirut, Lebanon, between July 1, 2002, and June 30, 2003. The hospitals selected were university affiliated and had a large number of deliveries (5,152 total for the year 2002–2003).Main Outcome Variables:Neonatal mortality and morbidity for infants admitted to the NICU were evaluated in relation to time of birth.Results:For the whole sample, mortality was higher for infants born during the night shift than for those born during the day shift. Mortality, morbidity, and brain asphyxia rates were also higher for infants born during the night shift and admitted to the NICU. Maternal risk factors and delivery complications were not consistently higher on the night shift.


2020 ◽  
Vol 24 (3) ◽  
pp. 229-234
Author(s):  
Hira Arif ◽  
Nadeem Ikram ◽  
Shangraf Riaz ◽  
Asma Nafisa

Introduction: About 30% of neonates develop thrombocytopenia during hospital admission. Inevitable and irreversible complications can be prevented by determining the risk factors of neonatal thrombocytopenia. The present study was undertaken to determine the risk factors and outcome of neonatal thrombocytopenia in neonates admitted to Neonatal Intensive Care Unit Benazir Bhutto Hospital Rawalpindi. Materials and Methods: A prospective study was conducted to evaluate the risk factors for neonatal thrombocytopenia (NT) in 160 neonates. Neonatal and maternal risk factors were recorded and neonates were categorized into three groups based on the severity of thrombocytopenia. Results: A higher percentage of the neonates 89 (55.6%) were male. The majority (61.9%) had moderate neonatal thrombocytopenia while 21.9% had severe neonatal thrombocytopenia. A highly significant difference was observed for the distribution of gestational age, platelet count, birth weight, and age at admission (for all p-value ≥0.0001) among different groups. Multivariate logistic regression revealed a significant independent association of prematurity, birth asphyxia, and low birth weight with neonatal thrombocytopenia. Conclusion: Prematurity, low birth weight, and birth asphyxia were the significant causes of Neonatal thrombocytopenia. The mortality rate increased significantly with the severity of thrombocytopenia.


2019 ◽  
Vol 6 (5) ◽  
pp. 1859
Author(s):  
Najia Hassan ◽  
Sujaya Mukhopadhyay ◽  
Sneha Mohan

Background: Preterm birth is a major cause of mortality and morbidity for newborns. Complications of prematurity are becoming more common as more survivors are spending time in Neonatal intensive care unit.Methods: A retrospective hospital based clinical observational study was conducted in NICU in Sharda hospital, a tertiary care centre in Greater Noida. Data regarding neonates′ age, sex, clinical presentation, maternal risk factors, complications and outcome were recorded.Results: A total of 133 preterm neonates were enrolled in the study. Maternal risk factors like Pregnancy induced hypertension (PIH) was seen in 19.5% cases, Urinary tract infection in 15% and Antepartum haemorrhage in 14.2% cases. Among the complications of prematurity, RDS was noted in 38.3% cases, Hyperbilirubinemia in 16.5% and feed intolerance in 15% cases. Sepsis was present in 3% of the preterm. Mortality rate was 7.5%. Most common cause of death was RDS.Conclusions: Pregnancy induced hypertension and Antepartum haemorrhage were important maternal risk factors for prematurity. Respiratory distress syndrome and perinatal asphyxia were the important causes of mortality in the present study.


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