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:
- 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.
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.