So, we have a neonate with an intracranial haemorrhage, diagnosed after birth due to decreased responsiveness. You had a number of questions for mum and suggestions for tests, including:

HISTORY:

• Medications taken during pregnancy:     only folic acid.
• Unexplained bleeding in mum:                 none.
• Trauma to gravid uterus:                             none.
• Mum’s health:                                               she’s a bit vague, but nothing declared.
• Previous pregnancies:                                  possible early miscarriage a few years ago.

Baby has had Vit K injection, and developed a small haematoma at the injection site.

TESTS:

FBC: Hb 202, plts 22, WCC 9

Film: thrombocytopenia, occasional large platelets, no other abnormality.

Coag screen/Factor assays/Fibrinogen:  appropriate for age.

What is your next step? What tests would be most useful at this point? How would you manage this patient immediately?

Answer on Twitter, remembering to include #teamhaem in your suggestions. Keep an eye out for case developments and share your ideas as we go.