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Anemia

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ANEMIA

WHAT IS NEWBORN ANEMIA?

• A baby who has decrease in number of rbc or less hemoglobin.


HEMORRHAGIC ANEMIA

• Neonatal period
• Enclosed hemorrhage: suggests obstetric trauma or severe
perinatal distress
• Caput succedaneum, cephalhematoma, intracranial hemorrhage,
visceral hemorrhage
• Defects in hemostasis
• Congenital coagulation factor deficiency
• Consumption coagulopathy: DIC, sepsis
• Vitamin K dependent factor deficiency
• Failure to give vit K causes bleeding at 3-4 days of age
• Thrombocytopenia: immune, or congenital with absent radii
• Iatrogenic blood loss due to blood draws
HEMOLYTIC ANEMIA

• Immune hemolysis: Rh incompatibility or


autoimmune hemolysis
• Nonimmune: sepsis, TORCH infection
• Congenital erythrocyte defect
• G6PD, thalassemia, unstable hemoglobins, membrane
defects (hereditary spherocytosis, elliptocytosis)
• Systemic diseases: galactosemia, osteopetrosis
• Nutritional deficiency: vitamin E presents later
PRESENTATION OF HEMOLYTIC ANEMIA

• Jaundice is usually the first symptom


• Compensatory reticulocytosis
• Pallor presents after 48 hours of age
• Unconjugated hyperbilirubinemia of > 10-12 mg/dL
• Tachypnea and hepatosplenomegaly may be present
HYPOPLASTIC ANEMIA

• Congenital
• Diamond-Blackfan syndrome, congenital leukemia, sideroblastic
anemia
• Acquired
• Infection: Rubella and syphilis are the most common
• Aplastic crisis, aplastic anemia
PRESENTATION OF HYPOPLASTIC
ANEMIA
• Uncommon
• Presents after 48 hours of age
• Absence of jaundice
• Reticulocytopenia
PRESENTATION OF OTHER FORMS

• Twin-twin transfusion
• Growth failure in the anemic twin, often > 20%
• Occult internal hemorrhage
• Intracranial: bulging anterior fontanelle and neurologic
signs (altered mental status, apnea, seizures)
• Visceral hemorrhage: most often liver is damaged and leads
to abdominal mass
• Pulmonary hemorrhage: radiographic opacification of a
hemithorax with bloody tracheal secretions
MANAGEMENT

• Simple replacement transfusion


• Exchange transfusion
• Nutritional replacement: iron, folate, vitamin E
• Prophylactic management with erythropoietin

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