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©2013 UpToDate ® Print Email Approach to the thrombocytopenic newborn infant Sick infant Neonatal history Is there a history of perinatal asphyxia? Does the child have meconium aspiration syndrome or respiratory distress syndrome? Is there evidence of infection? Necrotizing enterocolitis Sepsis/disseminated intravascular coagulation Does the child look abnormal? Toxoplasmosis, rubella, cytomegalovirus, herpes simplex Chromosome abnormality Is the child small for gestational age? Could the child have a thrombus? Were there indwelling catheters? Did the child have an intracranial hemorrhage? Maternal history Prenatal or perinatal infection Preeclampsia, hemolytic anemia, elevated liver enzymes, low platelet count Abnormal placenta Neonatal examination Head circumference, weight percentile Congenital anomalies: radial rays, thumbs, dysmorphic features Hepatosplenomegaly Blueberry muffin rash Hemangioma Neonatal laboratory values Abnormalities in the white blood cell count or hematocrit Hyperbilirubinemia or liver function test abnormalitites Evidence of coagulopathy or DIC Well infant Maternal history History of immune thrombocytopenic purpura or systemic lupus erythematosus? Previous infant with thrombocytopenia or family history of thrombocytopenic neonate? Infections during pregnancy? Drug use during pregnancy? Maternal platelet count Decreased, suggests autoimmune Normal, may be autoimmune or alloimmune process Neonatal examination Does the child look abnormal? Thrombocytopenia with absent radii Fanconi anemia Reproduced with permission from: George D, Bussel JB. Neonatal thrombocytopenia. Semin Thromb Hemost 1995; 21:276. Copyright © 1995 Theime.