[Hemorrhagic disease of newborn in children's hospital at damascus university and medical staff compliance to prophylactic vitamin k administration]

ABSTRACT

To determine the morbidity and mortality due to hemorrhagic disease of the newborn HDNB [vitamin K induced hemorrhagic disease] at Damascus University Children's Hospital [DUCH], and degree of medical staff compliance for applying related guidelines. A retrospective descriptive study of 307 patients with the diagnosis of HDNB at DUCH during 2000-2009. Ages ranged between 1 day and three months. Clinical, hematological and imaging studies were considered in all cases before final diagnosis of HDNB were established. A specimen of 307 patients were diagnosed having HDNB after the national guidelines for prophylactic vitamin K administration to newborns were established in 2000 by ministry of health. Early HDNB was found in 5.8%, classic HDNB in 14.3% and late HDNB in 78.8%. Home delivery contributed 32.9% of cases where hospital delivery 52.44% and private clinic delivery in 14.6%. Vitamin K injection after delivery was given in 14.2% [28 of 197] of well documented cases. Intra cranial hemorrhage was the most common complication especially in the late form of the disease 54.1%. Other hemorrhagic complications were as follows skin 14.9%, gastrointestinal 18.6% and circumcision 8.7%. Death occurred in 23% of cases [n=71]; seizures occurred in 10% of survivors HDNB is still present as a cause of morbidity and mortality in newborn period and early infancy in area of the study; vitamin K administration at delivery is not a routine practice despite of clear national guidelines