Some children between 24 and 72 hours show pathological conditions - increased bleeding from the umbilical wound, intestine, stomach. A group of similar conditions occurring in 0.2-0.5% of babies is called hemorrhagic neonatal disease. Often, this disease is the result of a lack of vitamin K in the body crumbs. In newborns breastfed, this disease can manifest itself in the third week of life. This is due to the presence in the milk of thromboplastin - a factor of blood clotting. The hemorrhagic disease of newborns that appears on this date is considered late.
There are two forms of this disease: primary coagulopathy in newborns, developing with vitamin K deficiency, and secondary, to which preterm and weakened children with weak functional hepatic activity are susceptible. About 5% of newborns suffer from a reduced level of K-vitamin-dependent clotting factors, if the mother during pregnancy took antibiotics, aspirin, phenobarbital or anticonvulsant drugs that affect hepatic function. In the risk group are also babies whose mothers suffered from toxicosis, enterocolitis and dysbacteriosis in the late term.
Clinical picture and diagnosis
With primary hemorrhagic diathesis, children experience nasal, gastrointestinal bleeding, bruising on the skin, and bruising. Such manifestations on the skin are called purpurea in medicine. Diagnosis of intestinal bleeding is carried out in the chair - stool on the diaper is black with a bloody rim. Often this is accompanied by bloody vomiting. Often, intestinal bleeding is single and uninvolved. Severe form is accompanied by continuous bleeding from the anus, bloody persistent vomiting. Sometimes even uterine bleeding can occur. Unfortunately, the consequences of severe hemorrhagic disease of newborns in the absence of timely medical care are fatal - a child dies of shock. The secondary form of the disease is characterized by the presence of infection and hypoxia . In addition, cerebral hemorrhage, lungs, and the ventricles of the brain can be diagnosed.
Diagnostics of hemorrhagic disease of newborns is based on clinical data and results of subsequent studies (blood smear, thrombotest, platelet count, activity of clotting factors and hemoglobin). At the same time, the newborn is tested for other hemorrhagic diathesis: hemophilia, Willebrand disease, thrombastenia.
Treatment and prevention
If the course of this disease is uncomplicated, then the prognosis is generally favorable. In the future, transformation into other types of hemorrhagic diseases does not occur.
Treatment of any bleeding in children of the first days of life begins with intramuscular injection of vitamin K, in which the body lacks. It is necessary to monitor thrombotest to monitor the alignment of K-vitamin-dependent clotting factors.
Prevention of this disease consists in a single injection of Vikasol to babies, who were born from a pregnancy with toxicosis . In a similar prophylaxis, newborns are also needed in the state of asphyxia as a result of an intracranial trauma or intrauterine infection.
Women who have had various diseases in the past that are associated with increased or pathological hemorrhage should be monitored throughout the pregnancy.