Anemia of Prematurity - Portal Neonatal

Physical: The presence of any of the following physical findings should prompt further diagnostic
evaluation:
• Twinning
• Hydramnios
• Exanthem or other evidence of intercurrent viral illness
• Herpetic lesion(s) or chancre(s)
• Decrease in fetal movements
Causes: The underlying physiologic flaw for the usual hydropic fetus is an elevated CVP secondary
to faltering cardiac output.
• Hematologic events, which lead to profound anemia and have been recognized to trigger
hydrops fetalis, are summarized in Table 1.
Table 1. Hematologic Causes
Isoimmunization (hemolytic disease of the newborn, erythroblastosis)
o Rh (most commonly D; also C, c, E, e)
o Kell (K, k, Kp, Js[B])
o ABO
o MNSs (M, to date)
o Duffy (Fy b )
Other hemolytic disorders
o Glucose phosphate isomerase deficiency (autosomal recessive)
o Pyruvate kinase deficiency (autosomal recessive)
o G-6-PD deficiency (X-linked dominant)
Disorders of red cell production
o Congenital dyserythropoietic anemia types I and II (autosomal dominant)
o Diamond-Blackfan syndrome (autosomal dominant)
o Lethal hereditary spherocytosis (spectrin synthesis defects) (autosomal recessive)
o Congenital erythropoietic porphyria (Günther disease) (autosomal recessive)
o Leukemia (usually associated with Down or Noonan syndrome)
o Alpha-thalassemia (Bart hemoglobinopathy)
o Parvovirus B19 (B19V)
Fetal hemorrhage
o Intracranial or intraventricular
o Hepatic laceration or subcapsular
o Placental subchorial
o Tumors (especially sacrococcygeal teratoma)
o Fetomaternal hemorrhage
o Twin-to-twin transfusion
o Isoimmune fetal thrombocytopenia