Case 30 – update 1

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.

About TeamHaem

Online education and discussion about all things haematological
This entry was posted in Paediatric haematology, Platelet disorders, Transfusion and tagged , . Bookmark the permalink.

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