Hemorrhagic disease of newborn

Hemorrhagic disease of the newborn - a group of syndromes caused by a transient failure in the early neonatal period, certain blood clotting factors.

Etiology and pathogenesis. It occurs in two forms (primary -defitsit vitamin K and secondary, which develops in frail or premature babies voluntary basis and is the result of a simple shortage of vitamin K). The disease is intravascular coagulation caused by reduced activity of vitamin K-dependent factors II-VII-IX and X without changing the number of platelets and red blood cells without fragmentation.

The clinical picture. When the primary form of hemorrhagic symptoms appear between the 2nd and 4th day of life in the form of gastro-intestinal and nasal bleeding, generalized ecchymosis, hematomas. The general condition of the child is not suffering. Prothrombin time is prolonged, and the majority of children there is a shortage of factors II-VII-IX and X under the normal factor V. After administration of vitamin K is faster positive dynamics. Apparently, there is a more pronounced deficiency of vitamin K, which is observed in healthy children in the neonatal period.

In the secondary form of the children, as a rule, have signs of hypoxia or infection. Along with these phenomena occur bleeding cerebral hemorrhage, cerebral ventricles, pulmonary hemorrhage, etc. are detected defects in a variety of blood coagulation: a. A moderate prolongation of prothrombin time, low levels of factors V and VII, a decrease in platelet count, often in violation of their functions. The effect of vitamin K is low.

Diagnosis is based on clinical data and the results of hematological studies (trombotest, the definition of the combined activity of II and Factor VII, platelet count, hemoglobin, blood smear, etc.).

Differential and d and g n o s conduct with other hemorrhagic diathesis.

Treatment. Disposable parenteral administration of vitamin K, 100 mg controlled trombotesta (alignment clotting factors, vitamin K-dependent) inside menadione for 3-4 days 0.003-0.004 g / d followed by a break for 3-4 days in heavy sluchayah- quick frozen plasma infusion rate of 10 ml per 1 kg of body weight, while the introduction of vitamin K.

The prognosis of primary form favorable for secondary - serious. Prevention is the appointment vikasola children born from pregnancies that occur with toxicity, as well as in diseases of the mother; children are able to asphyxia intracranial birth trauma, intrauterine infection.