Maternal IV Hematology

• Hematologic disorders often called

  Blood Dyscrasias
• Where does formation of blood cells begin

  Fetal yolk sac
• How many months does intrauterine life to begin forming blood components in the liver and spleen

  2 months
• At approximately month 4, the ____ becomes and remains the active center for the origination of blood cells

  Bone Marrow
• As in extrauterine life, this serves as the organ for the destruction of blood cells once their normal life span has passed.

  Spleen
• Blood plasma contains:


  Proteins, Hormones, Enzymes and Electrolytes
• Formed elements which are most affected by hematologic disorders in children are

  rbc, wbc, platelets
• It function as chiefly to transport oxygen to and carry carbon dioxide away from body cells.

  Erythrocytes or RBC
• RBCS are formed under the stimulation of - a hormone produced by the kidneys that is stimulated whenever a child has tissue hypoxia.

  Erythropoietin
• Overproduction of RBCs

  Polycythemia
• Large, nucleated cells


  Erythroblasts
• Mature cells 


  Normoblast
• mature, non nucleated erythrocytes

  Reticulocytes
• the end of their life span (about 120 days), ery- throcytes are destroyed through phagocytosis by reticuloen- dothelial cells, found in the highest proportion in the spleen.
• At birth, an infant has approximately 5 million RBCs per cubic millimeter of blood.
• The component of RBCs that allows them to carry out the transport of oxygen is

  Hemoglobin
• Hemoglobin during fetal life: It is composed of two alpha and two gamma polypeptide chains.
• At birth, 40% to 70% of the infant’s hemoglobin is fetal hemoglobin (hemoglobin F)
• Hemoglobin A is composed of two alpha and two beta chains
• Hemoglobin levels are highest at birth (13.7 to 20.1 g/100 mL)
• Indirect bilirubin is fat soluble and cannot be ex- creted by the kidneys in this state.
• Indirect bilirubin is converted by the liver enzyme glucuronyl transferase into direct bilirubin.
• WBC or ___ are nucleated cells.

  Leukocytes
• Ratio WBC and RBC

  1:500
• Their primary function is defense againts anyigen invasion

  Leukocytes or WBC
• Two forms of WBCs

  • granulocytes
  • agranulocytes
• With granules in the cell cytoplasm; they are also referred to as polymorphonuclear forms

  Granulocytes
• Those without granules in the cell cytoplasm

  Agranulocytes
• Types of Granulocytes: Neutrophils Eosinophils Basophils
• Types of Agranulocytes: Lymphocytes and Monocytes
• The WBC count in newborns is approximately 20,000 per cubic millimeter, a high level caused by the trauma of birth.
• They are round, non nucleated bodies formed by the bone marrow. Their function is capillary hemostasis and primary coagulation.

  Thrombocytes
• The normal range is 150,000 to 300,000 per cubic millimeter after the first year.
• Immature thrombocytes


  megakaryocytes
• It is an inherited disorder of blood coagulation.

  Hemophilias
• Hemophilia A is the classic form of hemophilia is caused by deficiency of the coagulation component factor VIII, the antihemophilic factor.
• Hemophilia A is transmitted as sex-linked recessive trait.
• Factor VIII is an intrinsic factor of coagulation, so the intrinsic system for manufacturing thromboplastin is incomplete. The child’s coagulation ability is not absent because the extrinsic or tissue system remains intact. Because of this system, the child’s blood will eventually coagulate after an injury.
• Hemophilia often is recognized first in the infant who bleeds excessively after circumcision.
• With hemophilia, the platelet count and prothrombin time are normal