DEFINITION
Anemia is a disease characterized by too few red blood cells
(erythrocytes) in the blood.
CAUSE
Normally, the bone marrow does not produce red blood cells
that is new at birth until the baby was about 3 or 4 weeks. As a result,
decrease the number of red blood cells slowly (so-called physiologic anemia)
during the first 2-3 months.
Anemia is more severe in newborns can result from:
·
Blood loss
·
Destruction of red blood cells excessive
·
Impaired formation of red blood cells
·
More of the above processes can occur at the
same time.
Blood loss in newborns can occur in various ways, among
others:
·
If the newborn is positioned higher than the
mother's abdomen before the umbilical cord is clamped, resulting in
feto-maternal transfusion, where many fetal blood flowing in through the
placenta into the maternal circulation, or too much blood is trapped in the
placenta during delivery.
·
In case of twin-to-twin transfusion, where many
fetal blood flow to the fetus twin. This can lead to anemia in the fetus that one
and polycythemia (too much blood) on the other fetus.
·
If the placenta separates from the uterine wall
prematurely (placental abruption) or if there is a tear in the umbilical cord.
Destruction of red blood cells that can occur due to
excessive:
·
Hemolytic disease of the newborn, in which a
large number of red blood cells are destroyed by antibodies produced by the
mother during the fetus in the womb
·
Abnormalities of shape red blood cells, for
example in sickle cell disease (sickle cell disease)
·
Lack of the enzyme G6PD (glucose 6 phosphate
dehydrogenase) in red blood cells
·
Acquired infection before the baby is born, for
example rubella infection, toxoplasmosis, cytomegalovirus, herpes simplex, or
syphilis.
· Acquired bacterial infections of newborns during
or after birth.
In rare cases, a failure of fetal bone marrow to produce red
blood cells, causing anemia. Some genetic disorders that can lead to impaired
formation of red blood cells include Fanconi anemia and Diamond-Blackfan
anemia. Certain infections (such as cytomegalovirus infection, syphilis, and
HIV) can also cause barriers to the bone marrow to produce red blood cells.
SYMPTOMS
Most infants with mild or moderate anemia have no symptoms.
Infants with moderate anemia can appear limp, difficulty eating, or can be
asymptomatic.
Newborns who suddenly lose a large amount of blood during
delivery could go into shock and looked pale, with a rapid heart rate, low
blood pressure, and breathing fast and shallow. In addition, there is increased
production of bilirubin (hyperbilirubinemia) due to the destruction of red
blood cells, which causes the skin and whites of the baby's eyes appear yellow
(jaundice). In severe cases, bilirubuh high levels can cause brain damage
(kernicterus).
DIAGNOSIS
Diagnosis is based on symptoms exist, and confirmed by blood
tests.
TREATMENT
Most babies develop anemia, which are lightweight, so it
does not require any treatment. However, newborns who suffered massive blood
loss quickly, often during childbirth, need to be overcome by giving
intravenous fluids, and can be followed by administration of a blood
transfusion.
Very severe anemia due to hemolytic disease can require
blood transfusions, but anemia is often overcome by the exchange of blood
transfusion, which bilirubuh levels lowered and the number of red blood cells
increased. On exchange blood transfusion, a small amount of blood is taken
gradually and replaced with donor blood in the same amount.
If the blood loss occur during childbirth, immediately given
a blood transfusion. If the cause is the destruction of red blood cells which
is excessive, it can be done transfusion locker, where the baby's blood is
replaced with fresh blood. Red blood cells are damaged, bilirubin and
antibodies from the mother's body dumped. Blood transfusion is done if symptoms
are severe anemia.
REFERENCE
- K, Arthur E. Anemia in the Newborn. Merck Manual Home
Health Handbook. 2009.
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