Prevalence of thrombocytopaenia in neonates admitted in neonatal high care unit of Pelonomi Tertiary Hospital Bloemfontein between January 2017 and June 2017
| dc.contributor.advisor | Van Rooyen, J. | |
| dc.contributor.author | Onwugbolu, Anselm Uche | |
| dc.date.accessioned | 2022-03-16T11:37:19Z | |
| dc.date.available | 2022-03-16T11:37:19Z | |
| dc.date.issued | 2019-08 | |
| dc.description.abstract | BACKGROUND: Thrombocytopaenia is the most common haematological abnormality, besides anaemia, found in the neonates admitted to a neonatal intensive care unit. Even though most cases are mild or moderate, requiring minimal or no intervention, and resolving spontaneously within the first week of life; a few infants, especially the very sick ones or the extremely low birth weights (<1000g), may present with severe and in some cases persistent thrombocytopaenia, which may require intervention such as platelet transfusion. OBJECTIVES: The primary objective of this study was to determine the prevalence of thrombocytopaenia in neonates admitted to the neonatal high care unit (NHCU) of Pelonomi Tertiary Hospital (PTH). METHODS: The study was a retrospective descriptive study conducted on 694 infants admitted to the NHCU of PTH between January 2017 and June 2017. Data included were neonatal demographic information, information regarding the clinical data of neonate and the mother obtained from the neonatal admission book used routinely at PTH by the admitting medical doctor. Infants with thrombocytopaenia were identified using the National Health Laboratory Service web results viewer. The data regarding the rate of performance of platelet count per patient in the cohort group was not collected as the primary objective was to determine whether or not thrombocytopaenia was present in the samples taken within the 72 hours of birth. Also, the common reason for doing blood investigations in the cohort group was not specified during the data collection because this attribute was not documented in the patients’ records. The data analysis was performed using the SAS System version 9.4. RESULTS: During the study period, a total of 694 neonates were admitted to the NHCU of PTH. Of these, 16.3% (n=113) infants were diagnosed with thrombocytopaenia (platelet count < 150 x 109/L), but 5 neonates were excluded in the study as their medical files were either incomplete or missing. Of the remaining 15.6% (n=108) neonates with defined thrombocytopaenia whose medical files were available, thrombocytopaenia was almost equally distributed across the gender, 50.9% (n=55) for females, and 49.1% (n=53) for male infants; low birth weight infants (1500 - 2499g) were mostly affected, 41.7% (n=45). According to gestational age, infants born between 32 and 37 weeks of gestation were mostly affected than others, 50% (n=54). Thrombocytopaenia was seen more in neonates whose birth weight was appropriate for their gestational age, 59.3% (n=64), than in small for gestational age counterparts, 38.9% (n=42). Early onset thrombocytopaenia (≤ 72h of life) occurred in 55.6% (n=60), while 44.4% (n=48) were of late onset (>72h of life). According to severity, neonatal thrombocytopaenia were predominantly mild, 51.9% (n=56). Twenty infants (18.5%) were diagnosed with sepsis based on a positive blood culture (bacterial and fungal), including 4 infants (20%) who demised. Of these, gram negative sepsis was the most common, 55% (n=11), with a mortality rate of 36.4% (n=4). Six infants (5.6%) had confirmed congenital abnormality with thrombocytopaenia. 3 of these infants (50%) were confirmed Trisomy 21. Sixteen (14.8%) of the infants diagnosed with thrombocytopaenia developed IVH. 43.8% (n=7) of these infants demised. NEC was seen in 15.7% (n=17), with 3 deaths (17.6%) occurring in this group. Of the 108 infants confirmed with thrombocytopaenia, only 3.7% (n=4) received a platelet transfusion in our unit, including 3 (75%) who demised. The most common maternal conditions were PET 29.6% (n=32), and PIH 21.3% (n=23). The study showed that chorioamnionitis was not a common maternal variable found in babies diagnosed with thrombocytopaenia in our unit, as only 0.93% (n=1) of this variable was identified during the study. Other main outcome measures identified were number of infants with thrombocytopenia discharged alive 87% (n=94) vs those who demised 13% (n=14). An equal gender distribution for mortality was seen with 50% mortality occurring in male and female infants. CONCLUSION: The prevalence of neonatal thrombocytopaenia in NHCU of PTH between January 2017 and June 2017 was 15.6%. The thrombocytopaenia which were mostly mild (51.9%), occurred slightly more in female infants than their male counterparts (50.9% vs 49.1%). Of these, the low birth weight infants were mostly affected (41.7%). The study confirms thrombocytopaenia is a common problem in our unit, thus physicians caring for the infants must be aware of this in order to curb the morbidity and mortality burden thereof. | en_ZA |
| dc.identifier.uri | http://hdl.handle.net/11660/11541 | |
| dc.language.iso | en | en_ZA |
| dc.publisher | University of the Free State | en_ZA |
| dc.rights.holder | University of the Free State | en_ZA |
| dc.subject | Dissertation (M.Med. (Paediatrics and Child Health))--University of the Free State, 2019 | en_ZA |
| dc.subject | Neonate | en_ZA |
| dc.subject | Neonatal thrombocytopaenia | en_ZA |
| dc.subject | Prevalence | en_ZA |
| dc.subject | Neonatal high care unit | en_ZA |
| dc.subject | Prematurity | en_ZA |
| dc.subject | Gestational age | en_ZA |
| dc.subject | Birth weight | en_ZA |
| dc.subject | Birth asphyxia | en_ZA |
| dc.subject | Sepsis | en_ZA |
| dc.subject | Necrotising enterocolitis | en_ZA |
| dc.title | Prevalence of thrombocytopaenia in neonates admitted in neonatal high care unit of Pelonomi Tertiary Hospital Bloemfontein between January 2017 and June 2017 | en_ZA |
| dc.type | Dissertation | en_ZA |