Jebmh.com Original Research Article J. Evid. Based Med. Healthc., pISSN- 2349-2562, eISSN- 2349-2570/ Vol. 6/Issue 29/July 22, 2019 Page 1972 STUDY OF PERIPHERAL SMEARS IN NEONATES Blessy Mary Thomas 1 , Reni Gee Varghese 2 1 Assistant Professor, Department of Pathology, Believers Church Medical College, Kerala. 2 Consultant Paediatrician, Sanjivini Hospital, Aleppy District, Kerala. ABSTRACT BACKGROUND The haematological parameters in a newborn are distinctly different from the normal adult values. NRBCs are immature RBCs normally seen in the peripheral blood of neonates up to 5 th day of life. At birth, 3 to 10 NRBCs per 100 WBCs are present. Premature birth and foetal hypoxia can cause the number to increase. NRBC count in umbilical venous blood of neonates has been reported as a possible marker of perinatal asphyxia. Leukocytosis refers to an increase in the total number of WBCs due to any cause. Thrombocytopenia can be a marker of an underlying disease as well as an obvious risk factor for haemorrhage. We wanted to study the variations in RBC, WBC, and platelets in peripheral smear of neonates and correlate them with the clinical findings. METHODS 300 cases were undertaken in this prospective study held between January 2012 and September 2013. Peripheral smear slides of all term neonates born in A. J. Hospital, Mangalore during this time period were taken and stained with Leishman’s stain. The data obtained was extensively studied and statistical analysis was done by Pearson’s Chi square test and Fischer’s Exact test. RESULTS The mean age of the study group was 1.29 days with female predominance, constituting 67%. 94.3% cases had normal RBC morphology. Anaemia amounted to 5.7% (17) cases. 91% cases had normal WBC count and 9% (27) cases had leukocytosis. HSS score was 4 for 8% (24) cases of which 7% (21) cases had leukocytosis and 1% (3) cases had normal WBC count. HSS score was 5 for 10% (3) cases, of which 7% (2) cases had leukocytosis and 3% (1) cases had normal WBC count. Normal platelet count was seen in 89.7% (269) cases with thrombocytopenia in 10.3% (31) cases. CONCLUSIONS Peripheral blood film remains a very useful diagnostic tool in haematological assessment, and assessing the HSS score is important as it is a useful test to distinguish the infected from the non-infected newborn which will help the clinicians to reach a probable diagnosis, decreasing the death toll and institute a rational approach towards patient medication. KEYWORDS Neonates, Peripheral Smear, NRBC, Thrombocytopenia. HOW TO CITE THIS ARTICLE: Thomas BM, Varghese RG. Study of peripheral smears in neonates. J. Evid. Based Med. Healthc. 2019; 6(29), 1972-1977. DOI: 10.18410/jebmh/2019/401 BACKGROUND A peripheral blood smear is a glass microscope slide coated on one side with a thin layer of venous blood. The slide is stained with Leishman’s stain, and examined under a microscope. Microscopic examination of the peripheral blood is used to supplement the information provided by automated cell counter. However, precise classification of abnormal cells requires a trained haematologist, a well- made peripheral blood smear, and a light microscope with good optical characteristics. Peripheral blood smear examination provides information that cannot be obtained from automated cell counting. Haematologic values in neonates differ significantly from those in older children and adults. Quantitative and qualitative differences are present as a reflection of the developmental changes during fetal haematopoiesis and so correlate with gestational age. At birth, the haemoglobin, mean corpuscular volume, and WBC counts of term newborns are significantly higher than those of older children and adults, and in preterm neonates the differences are even more pronounced. This review explores these differences and the major factors that account for them from the haematology laboratory standpoint. Early diagnosis of neonatal septicaemia is a vexing problem because of its nonspecific clinical picture. Bacterial infection in the newborn still account for a considerable morbidity and mortality. This is because the newborn especially the premature are prone to serious Financial or Other, Competing Interest: None. Submission 01-07-2019, Peer Review 08-07-2019, Acceptance 15-07-2019, Published 22-07-2019. Corresponding Author: Dr. Blessy Mary Thomas, Assistant Professor, Department of Pathology, Believers Church Medical College Hospital, Thiruvalla, Kerala. E-mail: blessy416@gmail.com DOI: 10.18410/jebmh/2019/401