Evaluation and management of thrombocytopenia in the neonatal intensive care unit

Neonatal thrombocytopenia in I C UThrombocytopenia is one of the most common hematological problems among neonates in the neonatal (Sola et al., 2001).Definition of thrombocytopenia: By the end of the first trimester of pregnancy, the fetal platelet count has already reached 150×109/l and rises further to 175-250 × 109/L by the middle of the second trimester (Pahel et al., 2000).Thus, platelet counts of < 150 × 109/L define thrombocytopenia intensive care unit (NICU).Roughly one-quarter of all NICU patients and half of all sick preterm neonates develop thrombocytopenia in any neonate regardless of gestational age.There are only three kinetic mechanisms responsible for thrombocytopenia in neonate(i) Decreased platelet production, Increased platelet destruction,(ii) platelet sequestration (mostly secondary to hypersplenism), or a combination of these processes.Recent studies show that most cases of neonatal thrombocytopenia fall into two main groups depending upon the age of the neonate when the thrombocytopenia first develops (Bussel et al., 2001).1.Early-onset thrombocytopenia develops either in utero or within the first 72 hours of birth.2.Late-onset thrombocytopenia presents after the first 72 hours of age;Treatment of neonatal thrombocytopenia must always begin with vigorous therapy for the precipitating cause(s). Following this, with the exception of immunoglobulin for immune thrombocytopenia’s, platelet transfusion remains the only available therapy.