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Djajadiman Gatot
Department of Child Health, University of Indonesia Medical School/Dr. Cipto Mangunkusumo Hospital, Jakarta
Health Professions Medicine & Pharmacology

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Incidence and risk factors of neonatal thrombocytopenia: a preliminary study Nila Kusumasari; Rinawati Rohsiswatmo; Djajadiman Gatot; Darlan Darwis
Paediatrica Indonesiana Vol 50 No 1 (2010): January 2010
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (343.074 KB)

Abstract

Background Thrombocytopenia is the most common hematological abnormality in the neonatal period. Hemorrhagic manifestations are found in 10% cases of thrombocytopenia. Neonatal thrombocytopenia commonly assumed due to sepsis, despite many risk factors that may caused thrombocytopenia.Objective To obtain incidence and risk factors of neonatal thrombocytopenia.Methods A cross sectional study was conducted in April 2009. Complete blood counts investigation was performed before age of 24 hours, medical conditions and risk factors of mothers and subjects were noted, as well as hemorrhagic manifestations. Subjects with thrombocytopenia were followed for 2 weeks. The risk factors consisted of hypertension in pregnancy, pre-eclampsia, eclampsia, intrauterine growth retardation, gestational diabetes mellitus, perinatal infection, asphyxia, sepsis, and necrotizing enterocolitis.Results Neonatal thrombocytopenia was found 17 (12.1%) of 140 subjects, consisted of 88.2% early onset and 11.8% late onset. Significant risk factor of mother was pre-eclampsia (PR 3.97, 95%CI 1.70 to 9.25), while significant risk factors of neonates were asphyxia (PR 5.66, 95%CI 2.49 to 12.86), sepsis (PR 5.33, 95%CI 2.33-12.19) and necrotizing enterocolitis (p=0.014; PR 9.2 95% CI 5.17 to14.84). We found 29.4% hemorrhagic cases of neonatal thrombocytopenia (i.e.,. skin, gastrointestinal, intracranial hemorrhage).Conclusions The incidence of neonatal thrombocytopenia was 12.2%. Significant risk factor of mother that caused thrombocytopenia was pre-eclampsia, while risk factors of neonates were asphyxia, sepsis and necrotizing enterocolitis.[Paediatr Indones. 2010;50:31-7].
Clinical characteristics of hemophilia A patients with hemarthrosis Setyo Handryastuti; Djajadiman Gatot; Arwin A. P. Akib
Paediatrica Indonesiana Vol 42 No 5-6 (2002): May 2002
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (549.373 KB) | DOI: 10.14238/pi42.5-6.2002.101-5

Abstract

Background Hemarthrosis is the most frequent bleeding manifestation of severe hemophilia. Repeated hemarthrosis will cause chronic arthropathy, which results in a physical disability.Objectives To obtain data of clinical characteristics of hemophilia- A patients with hemarthrosis (particularly chronic hemarthrosis) and to know the effect of on-demand therapy on joints of the patients.Methods We evaluated 102 hemophilia A patients in Pediatric Hematology and Oncology Division, Cipto Mangunkusumo Hospital for 6 months beginning from March 2001.Results The number of cases of chronic hemarthrosis was 22%,smaller than previous study (54%). Chronic hemarthrosis mostly occurred in hemophilia A patients who aged between 13-18 years, had severe hemophilia A and frequency of hemarthrosis more than 12 times a year, and also patients who did not receive adequate therapy. The joint which most frequently suffered from hemarthrosis were knee (26%), ankle (23%) and elbow (21%). The critical period for the first hemarthrosis was at the age of 2-12 years, and repeated  hemarthrosis episodes commonly occurred at the age 6-18 yearsowing to the child's increasing physical activities.Conclusion Hemarthrosis can be prevented and anticipated. It is important to notice the critical period when first hemarthrosisand repeated hemarthrosis occur. The certain joints like knee, ankle and elbow must be given more attention due to the risk ofrepeated hemarthrosis.
Co-Authors Arwin A. P. Akib Darlan Darwis Nila Kusumasari Rinawati Rohsiswatmo Setyo Handryastuti