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
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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,
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ed. St Louis: Mosby; 1999. p. 1438-69.
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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 1Nov.2024];43(3):82-. Available from: https://www.paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/666
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Received 2016-09-23
Accepted 2016-09-23
Published 2016-10-10
Accepted 2016-09-23
Published 2016-10-10
