Hemorrhagic Disease of the Newborn: Clinical Presentation and Response to treatment with Vitamin K

Background: Hemorrhagic disease of the newborn is a coagulation disturbance in newborns due to vitamin K deficiency. In our region most babies are delivered at home or in private clinics where vitamin K is not given in routine, leading to hemorrhagic disease of the newborn. The current study was conducted to determine the clinical presentation of hemorrhagic disease of the newborn and to assess the response to injection vitamin K. Material and Methods: This descriptive study was conducted at Neonatal Unit, Department of Child Health, Hayatabad Medical Complex, Peshawar, from January to December 2011. All neonates who presented with bleeding were admitted in the Neonatal Unit of Hayatabad Medical Complex, Peshawar. After sending blood for investigations, 2mg Vitamin K was injected intravenously. In babies with continuous bleeding, fresh frozen plasma was also given. PT and APTT were repeated after 6 to 12 hours and after one week. Results: 42 cases were included in the study. 76.2% were born at home and did not receive vitamin K at birth. 57% were low birth weight. 88% were breastfed. Gastrointestinal tract, skin and nasal mucosa were the common sites of bleeding. PT and APTT were prolonged in all the cases. Their values improved after 6 hours and normalized in one week. Conclusion: 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.