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Chapter 30


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Chapter 30

  1. 1. 1. Hsyslologlal anaemia f « 45%’. rise in blood plasma volume ' C - 15% use tn red all mus 2. Thvombotywpunia - typically a 10% Vail In platelet count 3. Coagulation A Increased coagulation lactovs - mdnxed flbvlnoiym _‘ “ 4. hound roqulnmam lav otythuopoleth ‘1 1 ~ 24 Volt! Increase In folaxe lequlverncnn H ‘ - 900 mg oi Iron requned (or mother ‘ ' ‘ and Inns 1.. -_ From Esscnnz-’i-'M'n zfovbgy. 15111 Em C A. V. Hofbmrld A P A H Moss l1;n. 'v, -:1 2011 by B| n1:Hw»<K| PulvI. ."0u lJd Fbuuu 30.1 Havmatodogbcal changes outmg pregnancy.
  2. 2. ‘U Incudenul Hypcnuwve Immune Others tnvombocytopenéa dasorders dxsovoers non 5-. =mm: »4.wm: .mgy_ c {an -. :A. v uonb-mas. P A H Mon. -. Puaur. v‘. «1 .1111 ! :y Nuzllvmll P. .m-. - nq L121 Flgun N2 causes ol tflomzocyiopetua during prognancy.
  3. 3. Nudentadmdcells in blood for 4-7 days 8 Haemoglobin (U80 Mtkulocyui (95) . . «. ... w»«. .. .1“ -nus. » c. .x ~. u: In. .ru. A w 1. . ~ -1.7.. "J‘.11xH-'1 an 1 : w 3 - man F‘ml1'. ‘1rIu 11:: Flame 30.3 Wpocal profile of the blood count in the neonatal period. MCV. moan oomuscular volume.
  4. 4. Anaemia 1 Retkulocyte count Low relkulocy-tea Raised retkulocytes / Check DAT Red cell aplasla ‘/ pawwims 3,9 DAT posltlva DAT negative‘ Diamond-Blackfan Probable HDN Check Kleihauer Alloirnmune antl-Kr. -ll / Kleihauer negative Klelhauer positive Check MCV Fetomaternal bleed Mcv normal or high ‘ m Membrane disorder G6PD deficiency Pyruvare lzinase deficiency _ From: E5<r-nml H. =.r~m. a1cIogy, em Edn. OA. V. Hollbrand A P. A H. Moss Publsah» «.1 2011 by 8x1ckw»; l« PL1C‘1,h: ng Lm, Figure 30.4 The Investigahon ol neonatal anaemia. GSPD, 9|ucose—6—phu5phale dehydrogenase; MCV. mean corpuscular volume. ' The d-ma anllglobulm last (DAT) test may be negatrve In haemorylic disease of me newbom (HDN) caused by A80 lncompallbimy.
  5. 5. (cl (bl lvrrfi . ‘1r1,«~‘- 94,. '1-41.] Antl-D FIYC Pry-nut‘: -., y1ll >21 A v H 'V'r1r-1AP A 1- Mr: . / v-1 ~<'zn>, < mm mm; LM Flqure 30.6 (a) Kleihauer test for lelal red cells; a deeply aosln- slaining cell corllairling fetal haemoglobin is seen at the centre. Haernoglobrn has been eluled lrom the other red cells by an lncubatlon at acid pH and these appear as colourless ghosls. (h) Delermnnanon by now cylometry of the number of Rh D letal cells an malerna! blood usnng lluorescam-label ol armbody lo Rh D. the mother belng Flhdd. (Courtesy ol Dr W Erber. )
  6. 6. aw; m -' AVHW'. r.<'. F‘AH‘| '‘ . .,. ..- yum In“ J‘ Figure 30.6 Doppler uttrasono graphy of the circle 0! Wullrs m a Imus The cursor is placed over the middle cerebral artery and an nncreased blood velacrly corre- lates wxth anaemra. (From Kumar S. and Regan F. (2005) BMJ 330, 1255-8. w-In perrrussmn )
  7. 7. (D) Figure 30.7 (a) Uiirasound realurea of hydrops feialis showing skin oedema. hepalome- galy and asciles. (From Kumar S. and Regan F. (2005) BMJ 330. 1255 8. with permission. ) (b) Rh haernulylir: disease 0! the newbom (erythroolaslosis fevafis): peripheral blood Iilm showing large numbers or aryflrroblaslsi polychromasia and crenaled cells.