PLATELET PARAMETERS AS A PROGNOSTIC VALUE IN NEONATAL SEPSIS | ||||
| Al-Azhar Journal of Pediatrics | ||||
| Article 5, Volume 19, Issue 2, June 2016, Page 1675-1690 PDF (306 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/azjp.2016.79085 | ||||
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| Abstract | ||||
| Background: Neonatal septicemia is one of the major health problems throughout the world. Despite improved neonatal care over the past decades, infections remain common and sometimes life-threatening in neonates admitted to the neonatal intensive care unit (NICU). Thrombocytopenia is also a common manifestation of neonatal septicemia. Neonatal septicemia requires rapid, accurate diagnosis and treatment for better prognosis. Thrombocytopenia occurs in early course of septicemia, therefore platelet count and its indices may be considered as early predictor for the diagnosis of septicemia. Aim of the study: to find out the occurrence of thrombocytopenia, the mean platelet volume(MPV) and platelet distribution width(PDW) among the cases of probable and culture proven neonatal sepsis, and to ascertain whether any association is present between counts and mortality rate. Patients and Methods: This study was comparative cross sectional study. It was conducted on 80 neonates with proven or probable neonatal sepsis admitted to NICU of Bab Alsheiryah Hospital (Al-AzharUniversity). The study carried out from May 2015 to February 2016. They were divided into 2 groups; group I consists of 26 neonates with culture proved sepsis neonatal sepsis and group II consists of 54 neonates with probable sepsis.For all neonates; History taking (to detect risk factors for sepsis), thorough clinical examination (to detect clinical signs of sepsis) and laboratory investigations (CBC, Platelets count, MPV, PDW, CRP and blood cultures) were done for all patients. Results: Our results revealed that the most common risk factor of neonatal sepsis was PROM>18h. Also poor feeding was the most common symptom followed by respiratory distress. There was negative correlation between platelet count and CRP. In the current study there was reduction in the platelet count in died cases. Also mean platelet volume (MPV) and platelet distribution width (PDW) are significantly higher in cases with neonatal sepsis (p value = 0.001). There was no significant difference in the platelet count in cultural proved sepsis group and suspected sepsis (p value = 0.334). There was no significant difference between thrombocytopenic and non-thrombocytopenic group according to blood culture. Conclusion: Thrombocytopenia is considered an early but nonspecific indicator of septicemia but other causes of neonatal thrombocytopenia should also be ruled out. Cases with thrombocytopenia have higher mortality rate. Low blood level of platelets are associated with bad prognosis, so follow up of levels of the platelets , MPV and PDW may act as a prognostic factors in neonatal sepsis. | ||||
| Keywords | ||||
| Neonatal Sepsis – Platelets; Mean Platelet Volume (MPV); Platelet Distribution width (PDW); Outcome | ||||
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