Anemia of Prematurity - Portal Neonatal

• Hypertension or beat-to-beat variability of blood pressure
• Coagulopathy
• Hypoxic-ischemic insults
• Respiratory disturbances (eg, hypercarbia, hypocarbia pneumothorax, hypoxemia, rapid
alterations in blood gasses)
• Acidosis
• Infusions of hypertonic solutions (eg, sodium bicarbonate)
• Anemia
• Vacuum-assisted delivery
• Frequent handling
• Tracheal suctioning
DIFFERENTIALS Section 4 of 11
Apnea of Prematurity
Hypermagnesemia
Hypoglycemia
Neonatal Sepsis
Periventricular Leukomalacia
WORKUP Section 5 of 11
Imaging Studies:
• Cranial sonography
o Sonography is the diagnostic tool of choice for screening examination and follow-up of
individuals with PVH-IVH. Screening is best performed when neonates are aged 3-7 days
because most hemorrhages occur before that age. Late screening (ie, when individual is
approximately aged 28 days) is useful to find the less common late hemorrhage and for
surveillance with regard to PVL.
o Sonography is also the diagnostic tool of choice for the follow-up of individuals with PVH-
IVH and posthemorrhagic hydrocephalus. Serial sonography is indicated weekly to follow
for progression of hemorrhage and the development of posthemorrhagic hydrocephalus.
• CT scan
Other Tests:
o Prior to the availability of sonography, CT scanning was used for diagnosis and follow-up.
o CT scanning is no longer used for diagnosis and follow-up in view of the safety and cost
effectiveness of sonography.
• Although not as useful as sonography, frontal-occipital circumference can be used as an
adjunct test in monitoring the progression of posthemorrhagic hydrocephalus.