Hyperbilirubinemia is defined as serum bilirubin concentration > 25 μmol/l. However, clinical presentation (jaundice (icterus) – yellowish colouring of the skin, sclera and mucosa) is apparent in newborns usually around hyperbilirubinemia of 80-100 μmol/l. It is one of the most common clinical and laboratory findings in both term and preterm infants (antenatally, placenta is responsible for…
The basic classification of neonatal anemia includes the following items: hemorrhagic anemia => blood loss (antenatal – perinatal – postnatal) hemolytic anemia (congenital vs. acquired) => increased destruction aplastic anemia => decreased production anemia of prematurity => specific to preterm infants Erythropoiesis Hemoglobin production begins around the third week of pregnancy in the cytoplasm…
Polycythemia is defined by venous hemoglobin concentration > 220 g/l or by hematocrit value > 0.65 during the first week of life. It correlates clinically with hyperviscosity syndrome. The common causes: chronic intrauterine hypoxia twin-twin transfusion syndrome in monochorionic-diamniotic twins (recipient twin) excessive placental transfusion Diagnosis Clinical signs dictated by the severity of hyperviscosity syndrome (infant…
There are significant differences (leukocyte abnormalities) in white blood cell (WBC) total and differential counts between newborns and older children. Alterations in WBC total and differential count can be an early sign of infection (leukopenia, leukocytosis, shift to the left). Total WBC counts should be always adjusted for given postnatal age – see Table. I/T index…
Newborns (preterm in particular) have relatively low levels of pro-coagulation factors (vitamin K dependent factors), diminished platelet functions (their levels are similar to adults), as well as low anti-coagulation factors (antithrombin III, protein C). Nevertheless, both pro- and anti-coagulation systems are in balance and hemorrhagic or thrombotic events are not usually observed. The levels of fibrinogen, factor V,…
Neonatal thrombophilia can cause both arterial and venous thromboembolic events. Thrombophilia results from the disrupted hemostatic system that normally consists of 4 integrated components: the coagulation system, endothelium and regulatory proteins, platelets, and fibrinolysis. The peak incidence of pediatric thromboembolic events occurs in neonates and infants < 1 year of age….
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