Book contents
- Frontmatter
- Contents
- List of contributors
- Foreword
- Preface
- 1 Neonatal hematology: a historical overview
- 2 Disorders of the fetomaternal unit
- 3 Erythropoiesis, red cells, and the approach to anemia
- 4 Anemia of prematurity and indications for erythropoietin therapy
- 5 Hypoplastic anemia
- 6 Hemolytic disease of the fetus and newborn
- 7 Neonatal hemolysis
- 8 Neonatal screening for hemoglobinopathies
- 9 Polycythemia and hyperviscosity in the newborn
- 10 Newborn platelet disorders
- 11 Neutrophil function and disorders of neutrophils in the newborn
- 12 Immunodeficiency diseases of the neonate
- 13 Hemostatic abnormalities
- 14 Transfusion practices
- 15 Umbilical-cord stem-cell transplantation
- 16 Neonatal oncology
- 17 Normal values and laboratory methods
- Index
- References
2 - Disorders of the fetomaternal unit
Published online by Cambridge University Press: 10 August 2009
- Frontmatter
- Contents
- List of contributors
- Foreword
- Preface
- 1 Neonatal hematology: a historical overview
- 2 Disorders of the fetomaternal unit
- 3 Erythropoiesis, red cells, and the approach to anemia
- 4 Anemia of prematurity and indications for erythropoietin therapy
- 5 Hypoplastic anemia
- 6 Hemolytic disease of the fetus and newborn
- 7 Neonatal hemolysis
- 8 Neonatal screening for hemoglobinopathies
- 9 Polycythemia and hyperviscosity in the newborn
- 10 Newborn platelet disorders
- 11 Neutrophil function and disorders of neutrophils in the newborn
- 12 Immunodeficiency diseases of the neonate
- 13 Hemostatic abnormalities
- 14 Transfusion practices
- 15 Umbilical-cord stem-cell transplantation
- 16 Neonatal oncology
- 17 Normal values and laboratory methods
- Index
- References
Summary
In health, the placenta functions marvelously well as the interface between the maternal and fetal circulations, providing nutrition, oxygen, fluid, and electrolytes and removing fetal waste and carbon dioxide. Disorders that disrupt placental physiology, and the presence of pathogens or toxins that can cross the placental barrier, can adversely affect the fetus. This chapter will discuss disorders of the maternal–fetal unit that result in hematologic abnormalities in the fetus and/or newborn infant.
Hemorrhagic disorders of the fetoplacental unit
The average blood volume of the fetoplacental circulation is roughly 110 ml/kg [1], and hence a relatively small amount of blood loss can be a sizable proportion of the fetal blood volume. Placental abnormalities causing fetal blood loss are shown in Table 2.1. Such blood loss can be visible, as with placenta previa, or occult, as with fetomaternal bleeds or twin–twin transfusion syndrome. The clinician must suspect fetal blood loss if the neonate presents with shock and pallor. The placenta and cord should be inspected for pallor, a hematoma, or other anomalies. As discussed below, maternal blood should be studied for the presence of fetal cells.
Abruptio placenta and placenta previa
While the majority of blood loss with placenta previa or abruptio placenta is maternal, fetal blood loss can also occur [2, 3]. The frequency of neonatal anemia requiring transfusion increases with the severity of maternal bleeding [4].
- Type
- Chapter
- Information
- Neonatal Hematology , pp. 10 - 39Publisher: Cambridge University PressPrint publication year: 2005
References
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