| ID | 361 |
|---|---|
| Name | HEMORRHAGIC DISEASE OF THE NEWBORN |
| Cause | A deficiency in vitamin K is the main cause of hemorrhagic disease in newborn babies |
| Signs Symptoms | blood in your baby's bowel movements. blood in urine. oozing around the umbilical cord. |
| Diagnosis | Diagnosis: Prolonged PT & PIT Management:13-37 Prevention: All newboms should be given prophylactically 3 doses of injection vitamin K, Img i.m or 2mg orally at 4 hours, at 4th day, and at 4th week of life. Prophylactic vitamin K to the prepartal mother may also be beneficial. |
| Investigations | |
| Management | Oral vitamin K (2mg dose) repeated at 2-4 weeks and at 6-8 weeks. For infants weighing less than 1500 gm, 0.5 mg IM single dose is given |
| Introduction | Some times bleeding may occur in the newborn, usually in the first 2 to 5 days of life (but may be present at birth) in an apparently healthy infant. It is mostly a self-limited bleeding disorder caused by the deficiency of the vitamin K-dependent coagulation factors, such as factor II, VII, IX, & X. Cause: 1. Deficiency of vitamin K- dependent coagulation factors i.e II, VII, IX and X; the deficiency is whether due to hepatic immaturity or something else, is a matter of controversy. 2. It occurs most commonly in term infants and is due to vitamin-K deficiency and breast-fed infants, because, breast milk contains very low amounts of vitamin K. |
| History | |
| Etiology | A deficiency in vitamin K is the main cause of hemorrhagic disease in newborn babies |
| Clinical Features | Clinical feature: Manifestations of surface bleeding such as petechie and ecchymoses in the skin and mucous membranes; bleeding from the umbilical cord stump, circumcision, nose and sometimes internal bleeding e.g malena, hematuria etc. may occur. Occasionally very serious hemorrhagic complications, such as intracranial hemorrhage and even hypovolemic shock may develop.Clinical feature: Manifestations of surface bleeding such as petechie and ecchymoses in the skin and mucous membranes; bleeding from the umbilical cord stump, circumcision, nose and sometimes internal bleeding e.g malena, hematuria etc. may occur. Occasionally very serious hemorrhagic complications, such as intracranial hemorrhage and even hypovolemic shock may develop. |
| Preventions | Can easily be prevented by administering 1 mg IM of vitamin K within 1 hour of birth |
| Treatment | Treatment: 1. If there is active bleeding a slow i.v infusion or i.m injection of l-5mg of vitamin K, bleeding clinically stops within 2 hours and the patient becomes normal within 12-24 hours. In late hemorrhagic disease vitamin K, 2mg/week orally for the first 3 months of life, may prevent hemorrhage. 2. If intracranial or any severe or life-threatening hemorrhage occurs, infusion of fresh-frozen plasma or fresh whole blood (or both) 10-15ml/kg should be given immediately. |
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