Hematological problems Ayda khader Feb . 2018

Bleeding Bleeding is generally rare in the newborn, there are a small number of significant conditions that can result in bleeding of which the midwife should be aware. Blood from the gastrointestinal tract (vomiting or passed per rectum as malaena) is sometimes seen and the commonest cause is swallowed maternal blood. This is supported if there is a clear history of maternal bleeding and bloodstained amniotic fluid. The baby should be carefully evaluated and the possibility of bleeding from the gastrointestinal tract considered. This could occur if there was a clottng or platelet abnormality, or occasionally with some serious gastrointestinal disorders such as NEC.

Possible causes of bleeding abnormalities Vitamin K-deficient bleeding (VKDB) Thrombocytopenia  Haemophilia and other inherited problems

Haemophilia Haemophilia A is an X-linked recessive disorder, which therefore affects only boys. Females may be carriers. diagnosis is often known or suspected antenatally because of a family history. investigation should occur after birth IM injections and invasive procedures should be avoided. The diagnosis can be made by checking a clotting profile should always be considered in a male baby who has unexpected bleeding.

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