Intracranial hemorrhage in hemorrhagic disease of the newborn
Keywords:
intracranial hemorrhage, hemorrhagic disease, vitamin K deficiency, prophylaxis, acquired prothrombin complex deficiency
Abstract
Background Hemorrhagic disease of the newborn (HDN) repre-sents a special case of vitamin K deficiency because the four vita-
min K-coagulation factors (factors II,VII,IX,X) are already at physi-
ologically low levels in the newborn. It responds to vitamin K
therapy.
Objective The aim of this study was to review the incidence, clini-
cal manifestation, and outcome of HDN.
Methods This was a retrospective cross sectional study on 22
patients hospitalized for HDN in the Department of Child Health,
Cipto Mangunkusumo Hospital from January 1997 until Decem-
ber 2001. Data were obtained from medical records.
Results The commonest age group (17 out of 22) was 1–3 month-
old. Normal delivery was found in 19 patients and only 3 patients
received prophylaxis vitamin K. Almost all of them (20 out of 22)
were exclusively breastfed. Seizure, pallor, decreased conscious-
ness, and bulging of the anterior fontanel were significant clinical
manifestations found in 21, 21, 13, and 9 patients respectively.
Based on brain USG and/or CT scan, intracranial hemorrhage was
found in 19 patients. Six out of 22 patients died and 7 patients
survived with handicap
Conclusion Intracranial hemorrhage due to vitamin K mostly oc-
curred at the age of 1 to 3 month-old. The commonest clinical mani-
festations were seizure, pallor, decreased consciousness, and
bulging of the anterior fontanel. Prevention by giving vitamin K rou-
tinely to all newborn babies is recommended
References
1. Casella JF, Pelidis MA. Disorders of coagulation fac-
tors. In: McMillan JA, DeAngelis CD, Feigen RD,
Warshaw JB, editors. Oski’s pediatrics: principle and
practice. 3 rd ed. Philadelphia: Lippincott Williams
&Wilkins; 1999. p. 1481-90.
2. Isarangkura PB. Vitamin K prophylaxis in newborn
babies. J Paediatr Obstet Gynecol 1991;17:5-9.
3. Chuansumrit A, Isarangkura PB, Hathirat P. Vita-
min K deficiency bleeding in Thailand: a 32-year
history. Southeast Asian J Trop Med Pub Hlth
1998;29:649-54.
4. Komberg AJ, Prensky AL. Cerebrovascular disease. In:
McMillan JA, DeAngelis CD, Feigen RD, Warshaw JB,
editors. Oski’s pediatrics: principle and practice. 3 rd
ed. Philadelphia: Lippincott Williams &Wilkins; 1999.
p. 1928-36.
5. Steig PE, Kase CS. Intracranial hemorrhage: diagnosis
and emergency management. Neurol Clin
1998;16:373-90.
6. Frank J, Aswal S. Neurologic disorders associated with
gastrointestinal diseases, nutritional deficiencies, and
fluid-electrolyte disorders. In: Swiman KE, Ashwal S,
editors. Pediatric neurology: principles & practice. 3 rd
ed. St Louis: Mosby; 1999. p. 1438-69.
7. Vitamin K Ad Hoc Task Force. American Academy of
Pediatrics. Controversies concerning vitamin K and the
newborn. Pediatrics 1993;91:1001-3.
tors. In: McMillan JA, DeAngelis CD, Feigen RD,
Warshaw JB, editors. Oski’s pediatrics: principle and
practice. 3 rd ed. Philadelphia: Lippincott Williams
&Wilkins; 1999. p. 1481-90.
2. Isarangkura PB. Vitamin K prophylaxis in newborn
babies. J Paediatr Obstet Gynecol 1991;17:5-9.
3. Chuansumrit A, Isarangkura PB, Hathirat P. Vita-
min K deficiency bleeding in Thailand: a 32-year
history. Southeast Asian J Trop Med Pub Hlth
1998;29:649-54.
4. Komberg AJ, Prensky AL. Cerebrovascular disease. In:
McMillan JA, DeAngelis CD, Feigen RD, Warshaw JB,
editors. Oski’s pediatrics: principle and practice. 3 rd
ed. Philadelphia: Lippincott Williams &Wilkins; 1999.
p. 1928-36.
5. Steig PE, Kase CS. Intracranial hemorrhage: diagnosis
and emergency management. Neurol Clin
1998;16:373-90.
6. Frank J, Aswal S. Neurologic disorders associated with
gastrointestinal diseases, nutritional deficiencies, and
fluid-electrolyte disorders. In: Swiman KE, Ashwal S,
editors. Pediatric neurology: principles & practice. 3 rd
ed. St Louis: Mosby; 1999. p. 1438-69.
7. Vitamin K Ad Hoc Task Force. American Academy of
Pediatrics. Controversies concerning vitamin K and the
newborn. Pediatrics 1993;91:1001-3.
Published
2016-10-10
How to Cite
1.
Mangunatmadja I, Sundariningrum R, Pusponegoro H, Windiastuti E. Intracranial hemorrhage in hemorrhagic disease of the newborn. PI [Internet]. 10Oct.2016 [cited 26Apr.2024];43(3):82-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/666
Section
Articles
Authors who publish with this journal agree to the following terms:
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Received 2016-09-23
Accepted 2016-09-23
Published 2016-10-10
Accepted 2016-09-23
Published 2016-10-10
