Effect of prophylactic dose of vitamin K on occurrence of hemorrhagic disease in newborn

To determine the effect of prophylactic dose of Vitamin K on occurrence of hemorrhagic disease in newborn. Non randomized controlled study was conducted in Children Hospital Quetta during June to December 2009. Total 300 healthy full term neonates between 2[nd] to 7[th] days of life were included in the study. They are divided into 2 groups; group 1 consisted of 100 neonates who were given prophylactic dose of vit K in a dose of 1.0mg intramuscularly and group 2 consisted of 200 neonates who did not receive prophylactic dose of Vit K as their parents did not agree. They were followed up till 12 weeks of life, for development of bleeding from any site. There are 3 types of Hemorrhagic disease of newborn according to age of manifestation. In early onset bleeding occurred within 24 hours of life, in classical onset bleeding occurred from 2[nd] to 7[th] days of life and in late onset bleeding occurred during 2[nd] to 12[th] week of life. In group 1 only 2 neonates [2%], out of 100 presented with late onset of hemorrhagic disease of newborn, one [50%] with gastrointestinal tract bleeding and other [50%] with subcutaneous bleeding. In group 2, out of 200neonates 14[7%] developed bleeding, 9 [64.3%] presented with classical onset and 5 [35.7%] with late onset. Commonest clinical manifestation in group 2 was gastrointestinal tract bleeding [28.8%], 2nd common manifestation was haematuria [21.4%] and umbilical cord bleeding [21.4%], followed by prolonged bleeding after circumcision [14.2%] and subcutaneous [14.2%]. Male to female ratio was 1.3:1

Hemorrhagic disease of the newborn: clinical presentation and response to treatment with vitamin k

1] To determine the clinical presentation of hemorrhagic disease of the newborn. 2] To assess the response to injection vitamin K in this condition. This was a descriptive, analytical study conducted from January, 2002 to December, 2002 in the National Institute of Child Health, Karachi. All patients who presented with bleeding were admitted in the neonatal unit of the National Institute of Child Health, Karachi. After sending blood for investigations, 2mg. Vitamin K was injected intravenously. In babies with continuous or profuse bleeding, fresh frozen plasma was also given. PT and APTT were repeated after 6 to 12 hours and after one week. Data collection was done by means of a proforma. Analysis was on SPSS version 8.0. 50 cases were included in the study 78% were born at home and did not receive vitamin K at birth. 72% were low birth weight. 80% were breastfed. Gastrointestinal tract, nasal mucosa and skin were the commonest sites of bleeding. PT and APTT were prolonged in all the cases. Their values improved after six hours and normalized in one week. Vitamin K deficiency causing hemorrhagic disease of the newborn is a common problem in neonates. It shows a dramatic response to vitamin K injection. It is more common in male, preterm and low birth weight babies

Hemorragia intraventricular en el recién nacido prematuro / Intraventricular hemorrage in preterm neonates

El presente trabajo es producto de una revisión de la patogénesis, incidencia, tratamiento y pronóstico de la hemorragia intraventricular en el recién nacido prematuro. En las publicaciones revisadas, que incluyen series importantes de seguimiento, esta patología se presenta en 25% de los infantes menores de 1500 gramos de peso, en los que tanto la morbilidad como la mortalidad es mayor que los recién nacidos normales, ya que el desarrollo de la hemorragia intraventricular, puede producir alteraciones de flujo sanguíneo cerebral en la inmadura matriz germinal y en la red microvascular. En consecuencia la prevención de la hemorragia intraventricular está directamente relacionada con su patogénesis. Se pregona que el uso de esteroides tipo dexametazona en dosis bajas en el período prenatal y bajas dosis de endometacina en el período postnatal, pueden dar mejor neuroprotección. El tratamiento quirúrgico es excepcional y tiene indicaciones bien precisas, cuando se demuestra certeramente una hidrocefalia progresiva tardía. Por lo tanto en los neonatos prematuros con hemorragia intraventricular el mejor tratamiento actual, es el usar un sistema de seguimiento médico y farmacológico...

Uso da vitamina K no periodo neonatal: parenteral x oral / Vitamina K in the newborn infant: parenteral x oral use

A vitamina K e amplamente utlizada logo apos o nascimento, para a prevençäo da doença hemorragica do recém-nascido. Esta patologia se apresenta sob varias formas: precoce, "clássica" e tardia, sendo esta última a de maior morbidade, por provocar hemorragias intracranianas. A vitamina K pode ser administrada por via parenteral ou oral, cada qual com suas vantagens e desvantagens. Ao se optar pela forma oral e necessario adotar um esquema de multiplas doses, para que a profilaxia da forma tardia seja eficaz

Doença hemorrágica do recém-nascido na forma tardia: descriçäo de casos / Late hemorragic disease of the newborn: case report

Objetivo: Chamar atençäo para a doença hemorrágica do recém-nascido em sua forma tardia, que poderá ter graves consequências, incluindo óbito e seqüelas neurológicas. Métodos: Säo apresentados e descritos quatro casos de recém-nascidos, com idaade variando de 12 a 21 dias de vida, diagnosticados como doença hemorrágica tardia por dificiência de vitamina k. Resultados: Nos casos apresentados as manifestaçöes hemorrágicas foram múltiplas. Os locais acometidos em nossos casos foram o aparelho digestivo, trato urinário, côto umbilical, aparelho respiratório e SNC. Conclusäo: O estudo mostra a importância da forma tardia da doença hemorrágica do recém-nascido, destacando-se sua possível gravidade, risco de morte e de seqüelas neurológicas. A administraçäo profilática de vitamina k após o nascimento, preconizada pela OMS, continua sendo a melhor forma de previnir a doença...