Study of neonatal thrombocytopenia in tertiary care NICU

Abstract

Context: 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 neonatal thrombocytopenia. The majority of episodes of neonatal thrombocytopenia are relatively mild and self- limiting but sometimes 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 prevalence,outcome and etiology of neonatal thrombocytopenia. Detail maternal history and neonatal physical examination done and Neonates were followed foroutcome,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 Pre eclampsia 64.8%, eclampsia73.3% and infection during pregnancy (PROM) 68.7%. Out of 140 neonates 135 (96.4 %) neonates were discharged. 5 (3.6%) neonates were died, of which 1 (2.1%) of mild, 1 (8.3%) of moderate and 3(60%) were having severe thrombocytopenia. The mortality in babies with severe thrombocytopenia was high.Conclusion:The prevalence of neonatal thrombocytopenia was 45%. The most common etiology associated with thrombocytopenia were maternal pre eclampsia, eclampsia and PROM followed by neonatal prematurity, sepsis, IUGR and NEC. Bleeding complication like intracranial bleed were significantly associated with severe thrombocytopenia. 60% of mortality was found in severe thrombocytopenic group.

Keywords:Neonatal Thrombocytopenia, Maternal pre eclampsia, eclampsia,Prematurity, Sepsis, IVH