الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
In busy NICUs evaluation and management of patients with neonatal thrombocytopenia is an everyday occurrence. In most cases, simple clinical and laboratory evaluation provides the cause of the thrombocytopenia and allows a prediction of its clinical course. Thrombocytopenia defined as platelet count of < 150x109 /L in any neonate regardless of gestional age.
The incidence of neonatal thrombocytopenia varies greatly from <1.1 in healthy term babies to around one third of neonates admitted to NICU. The incidence of Thrombocytopenia in preterm neonates in NICU is in much higher , reaching 22.35%, with severe thrombocytopenia (platelets <50 x109 /L) in 6% of all admission. Thrombocytopenia in the newborn rarely is indicative of aprimary disorder of megakaryopoiesis, but more often is the result of either systemic illness or transfer of maternal antibodies directed against fetal platelets. Our study aimed to estimated the incidence of severe thrombocytopenia which was defined as platelet count <60 x109 /L to all neonates admitted to our NICU. All study neonates(200) were divided into three groups according to the type of hemorrhage:
Group I: (minor hemorrhage) included 142 neonates , defined as one or more than of the following
-Blood stained oral, nasogastric, endotracheal secretions or stool.
-Hematuria (microscopic evidence of blood loss).
-petechial rash.
-oozing from puncture sites.
Group II:( major hemorrhage) included 20 neonates , as:
-Intraventricular hemorrhage (IVH).
-pulmonary hemorrhage.
-Rectal hemorrhage.
Gross hematuria.-
Group III: included 38 neonates with no evidence of bleeding .
All study neonates were subjected to the following:
1)-Full history taking including (Gestational age- Gender- Birth weight).
2)-Full clinical examination : ( anthropometric measurements - prescence of signs of associated clinical condition- type of hemorrhage).
3) Laboratory investigations:( Complete blood count-C reactive protien-Blood and urine culture -Liver and Kidney function tests-Urine and stool analysis).
4) Radiological investigations:( Chest X- ray-Abdomial and Cranial ultrasonography ).
Our results revealed that :
●There was a significant difference between the studied groups regarding weight and non significant difference between the studied groups regarding gestational age and postnatal age.
●Sepsis was the most common associated clinical condition in the studied groups.
●The most frequent associated maternal diseases were pregnancy induced hypertension and diabetes mellitus.
●Oozing from puncture sites (45.07%) and blood stained nasogastric secretions (42.25%) were the most common sites of hemorrhage in minor hemorrhage group .
●The most common sites of major hemorrhage was intraventricular hemorrhage (50%) followed by pulmonary hemorrhage (30%) and GIT hemorrhage(20%).
●There was a significant difference between the studied groups regarding platelet ,whole blood ,packed R.B.C.s transfusion and non significant difference between the studied groups regarding fresh frozen plasma transfusion.
The most frequent associated morbidity with neonatal thrombocytopenia is sepsis. Intraventricular hemorrhage is the most common type of major hemorrhage. Platelet transfusion are given frequently to neonates with major hemorrhage or prophylaxis in neonates with no evidence of hemorrhage .