As a consequence of vitamin k deficiency there is an impaired production of coagulation factors ii, vii, ix, x, protein c. Haemorrhagic disease of newborn linkedin slideshare. Hemorrhagic disease of the newborn hdn, now known vitamin k deficiency bleeding. Vitamin k deficiency bleeding vkdb, formerly known as hemorrhagic disease of the newborn, is a coagulopathy infants acquire due to insufficient vitamin k stores.
When the bleeding occurs inside the body, it can be difficult to notice. Bleeding in the brain is not very common in this condition. However, the bleeding can happen up to six months after birth. Hemorrhagic disease is a rare bleeding disorder that often develops due to the coagulation disturbance during first few days of the life of the baby. Clinical symptoms of late hemorrhagic disease of the newborn can be.
Many specific cases had been reported before 1894, when townsend first described the entity he called hemorrhagic disease of the newborn. Hemorrhagic disease definition of hemorrhagic disease by. As a result, its often called vitamin k deficiency bleeding, or vkdb. The most common sites of hemorrhage or bleeding are. The current proper diagnostic term that has been adopted is vitamin k deficiency bleeding vkdb, because vitamin k deficiency is not the sole cause of hemorrhagic disorders in preterm and term infants. Pdf late haemorrhagic disease of the newborn researchgate. Vitamin k deficiency bleeding vkdb of the newborn, previously known as haemorrhagic disease of the newborn, is a rare form of bleeding disorder that affects newborns and young infants due to low stores of vitamin k at birth.
Coagulation factors ii,vii, ix, x and other glaproteins protein c, protein s, protein z also depend on the presence of vitamin k for their activity. Hemorrhagic disease of newborn, now called vitamin k deficiency bleeding vkdb, caused by vitamin k deficiency, and its prevention in newborns was the subject for which henrick dam denmark and edward doisy usa were jointly awarded the nobel prize for medicine in 1943. Hemorrhagic disease of newborn definition of hemorrhagic. Vkdb could occur between 0 and 24 hours early, between two and seven days classic, or between eight days to 12 weeks and up to six months late after birth. Hemorrhagic disease is one of those alarming disorder that affects the newborn. Mcmillan in 1997, the canadian paediatric society revised its recommendations on the administration of vitamin k to newborn babies to prevent hemorrhagic disease of the newborn hdnb. The bleeding can occur anywhere on the inside or outside of the body. In the 1970s and early 1980s, several studies described a possible association between maternal use of aeds and hemorrhagic disease of newborns.
Mar 11, 2018 hemorrhagic disease the newborn hdn disseminated intravascular coagulation the neonatal period secondary process triggered primary disease. Original article from the new england journal of medicine hemorrhagic disease of the newborn. Hd is the most important infectious disease of whitetailed deer in the southeast united states and in virginia, and outbreaks occur almost every year. Vitamin k deficiency bleeding vkdb of the newborn is a bleeding disorder in babies. Forty years ago, hemorrhagic disease of the newborn occurred in 1% to 2% of newborn babies 1. Some vitamin k is also made by the good bacteria that live in our intestines. Among these antibodies are some which attack antigens on the red blood cells.
Bleeding problems often occur during the neonatal period. Incidence of late vitamin k deficiency bleeding in. Hemorrhagic disease of the newborn hdn, now known vitamin k deficiency bleeding disorder vkdbd, has been a recognized clinical entity for over 150 years, and the discovery of vitamin k led to a nobel prize for dam and doisy in 1943. Hemorrhagic disease of newborn, vitamin k dependent coagulation factors, intracranial hemorrhage. Pdf intracranial hemorrhage in hemorrhagic disease of. Dec 2017 the past the term hemorrhagic disease the newborn was used describe bleeding disorders neonates associated with traumatic birth hemophilia. Late haemorrhagic disease of the newborn hdn can occur owing to a lack of vitamin k prophylaxis, as a manifestation of an underlying disorder or idiopatically from the 8th day to 12 weeks after birth.
May 11, 2016 hemorrhagic disease of the newborn is a rare bleeding problem that can occur after birth. It commonly presents with intracranial haemorrhage with the risk of brain damage or death newborn infants have low stores of vitamin k, and human breast milk has low. While shaken baby syndrome may be your initial thought, hemorrhagic disease of the newborn hdnb, rare though it is, should be on your differential diagnosis list. Hemorrhagic disease of the newborn despite vitamin k. Without the clotting factor, bleeding occurs, and severe bleeding or hemorrhage can result. Complications of hemorrhagic disease of newborns include hypovolemic shock. Hemorrhagic disease of the newborn synonyms, hemorrhagic disease of the newborn pronunciation, hemorrhagic disease of the newborn translation, english dictionary definition of hemorrhagic disease of the newborn. May 20, 2019 previously, the term hemorrhagic disease of the newborn was used to describe bleeding disorders in neonates associated with a traumatic birth or hemophilia. Vitamin k is necessary for the synthesis of functional forms of coagulation factors ii, vii, ix, and x in the liver. In the past, the term hemorrhagic disease of the newborn was used to describe bleeding disorders in neonates associated with a traumatic birth or hemophilia. Hemorrhagic disease of the newborn boston childrens hospital. Although thrombocytopenia is the most common cause, coagulation problems often occur, and the two problems may coexist.
Hemorrhagic disease of the newborn, with clinical manifestations that range from purpura to intracranial hemorrhage, may stroke in the newborn. Approach to the bleeding newborn pubmed central pmc. Incidence of late vitamin k deficiency bleeding in newborns. Designprospective survey of all possible cases of haemorrhagic disease of the newborn as reported by consultant paediatricians using the monthly notification cards of the british paediatric surveillance unit and a follow up. Download pdf routine newborn care includes the prophylactic administration of vitamin k to the baby at birth to prevent the occurrence of hemorrhagic disease of the newborn hdn. For 150 years, families have come from around the corner and across the world, looking to boston childrens for answers. There are 2 subtypes of ehd virus and 5 subtypes of bluetongue in north america. Hemorrhagic disease of newborn 11 nineteen from the boston lyingin hospital and twelve from the in fants hospital. Hemorrhagic disease of the newborn is a rare bleeding problem that can occur after birth. Babies are born with very small amounts of vitamin k stored in their bodies, which can lead to serious bleeding problems if not supplemented. Introduction any haemorraghic manifestation due to deficiency of vitamin k dependent clotting factors is known as haemorraghic disease of newborn hdn.
If you have access to a journal via a society or association membership, please browse to your society journal, select an article to view, and follow the instructions in this box. Late hemorrhagic disease of the newborn hdn may occur without an underlying disorder or as a secondary manifestation of an underlying disorder. Vkdb was previously called hemorrhagic disease of the newborn. Hemorrhagic disease of the newborn jama pediatrics. Babies often have a low level of vitamin k for a variety of reasons. Mar 14, 2018 the term vkdb replaced the wording of hemorrhagic disease of the newborn since vitamin k deficiency bleeding may also occur in the postnatal period. Varavikova md, mph, phd, in the new public health third edition, 2014. Nowadays, the term hdn is replaced by vitamin k deficiency bleeding vkdb, as neonatal bleeding is often not due to vitamin k. Hemorrhagic disease of the newborn competently about. Hemorrhagic disease of newborn vkdb causes, symptoms. Hemorrhagic disease of the newborn a moderate decrease in factors ii,vii,ix,x normally occurs in all newborn infants by 4872 hours after birth, this is probably due to lack of free vit k from the mother and absence of bacterial intestinal flora normally responsible for vit k synthesis rarely in term and more frequently in preterm. The late hemorrhagic disease in a newborn occurs between the second and the twelfth week after birth.
Antiepileptic drugs in pregnancy and hemorrhagic disease. In contrast, late vkdb, with onset from 2 to 12 weeks of age, is most effectively prevented by parenteral administration of vitamin k. Vitamin k deficiency bleeding hemorrhagic disease of the. Late hemorrhagic disease of the newborn hdn presents 0. Pengertian hemorrhagic disease of the newborn hdn didefinisikan sebagai perdarahan spontanatau akibat trauma pada bayi yang berhubungan dengan defisiensi vitamin k danmenurunnya aktifitas faktor pembekuan ii, vii, ix, dan x dengan fibrinogen dan trombositnormal. Treatment of haemorrhagic disease of the newborn br med j 1941. Access to society journal content varies across our titles. Newborn hemorrhagic disease an overview sciencedirect. Hemorrhagic disease of the newborn american journal of obstetrics. These proteins are secreted into the blood and ultimately assist.
Acquired vkdb is more common in human neonates, which are very susceptible to vitamin k deficiency because of low stores at birth, poor placental transfer, low concentrations in milk, and lack of production by an immature intestinal microflora. Vitamin k deficiency bleeding is primarily a disease of the newborn, but such hemorrhage can occur beyond the neonatal period, especially if conditions such as short gut syndrome, intestinal bacterial overgrowth, and certain genetic conditions are present. Vkdb bleeding typically occurs in the nose, skin, gastrointestinal tract and umbilicus. Haemorrhagic disease of the newborn in the british isles. We describe here two cases of late hdn in infants who received vitamin k. Pdf intracranial hemorrhage in hemorrhagic disease of the. Hemorrhagic disease of the newborn bleeding infants. It commonly presents with intracranial haemorrhage with the risk of brain damage or death. Vitamin k deficiency bleeding vkdb is a bleeding problem that occurs in some newborns during the first few days of life.
Why is hemorrhagic disease of the newborn a concern. Haemorrhagic disease of the newborn wikimili, the free. Late hemorrhagic disease of the newborn hdn is a rare complication of vitamink deficiency and is especially associated with intracranial hemorrhage. Other articles where hemorrhagic disease of the newborn is discussed. Vkdb, formerly known as hemorrhagic disease of the newborn, is a bleeding disorder caused by low levels of vitamin k dependent clotting factors. It has been the standard of care since the american academy of pediatrics recommended it in 1961. Hemorrhagic disease of the newborn free download as word doc. The term haemorrhagic disease of the newborn hdn was coined by charles townsend in 1894 to describe an acquired bleeding disorder in the newborn due to vitamin k deficiency. Babies are normally born with low levels of vitamin k, an essential factor in blood clotting.
The first page of the pdf of this article appears above. Although the previous guideline indicated that oral vitamin k. Addresses and papers treatment of haemorrhagic disease of the newborn. Vitamin k deficiency bleeding or vkdb, occurs when babies cannot stop bleeding because their blood does not have enough vitamin k to form a clot. Hemorrhagic disease of the newborn jama pediatrics jama. Prevention of early vitamin k deficiency bleeding vkdb of the newborn, with onset at birth to 2 weeks of age formerly known as classic hemorrhagic disease of the newborn, by oral or parenteral administration of vitamin k is accepted practice. The extent of bleeding varies from skin bruising, subcutaneous haemorrhage, ecchymoses, umbilical bleeding to wide spread fatal intracranial.
Haemorrhagic disease of the newborn, also known as vitamin k deficiency bleeding vkdb, is a coagulation disturbance in newborn infants due to vitamin k deficiency. Vitamin k deficiency can cause severe haemorrhage in the newborn. Vkdb, formerly known as hemorrhagic disease of the newborn, is a bleeding disorder caused by low levels of vitamin kdependent clotting factors. You are on call in the emergency room, and a fiveweekold infant presents with apnea and convulsive movements. Hemorrhagic disease of the newborn breast feeding as a necessary factor in the pathogenesis james m. Late hdn frequently presents with intracranial haemorrhage, leading to high morbidity and mortality. Eight infants admitted to kocaeli university hospital with nine episodes of late hdn between january 2002. Newborn hemorrhagic disease an overview sciencedirect topics. Dec 19, 2019 vitamin k is a substance that our body needs to form clots and to stop bleeding. Selected abstract birth injuries of the newborn volume 9, issue 1, p147148, january 01, 1925. Hd is caused by two closely related viruses, epizootic hemorrhagic disease ehd or bluetongue virus.
The proper diagnostic term that has been adopted is currently vitamin k deficiency bleeding because vitamin k deficiency is not the sole cause of hemorrhagic disorders in preterm and ter. Objectiveto determine the incidence of haemorrhagic disease of the newborn in the british isles, study risk factors, and examine the effect of vitamin k prophylaxis. Vitamin k plays an important role in blood clotting. Controversies concerning vitamin k and the newborn.
A lack of vitamin k may cause severe bleeding in newborn babies. Classification, manifestations, and diagnosis view in chinese. Hemorrhagic disease of the newborn competently about health. Late hemorrhagic disease of newborn occurs after seventh day of life. The early form of hemorrhagic disease of a newborn is characterized by the appearance in the first days of life of bloody vomiting haematomesis, pulmonary hemorrhage, hemorrhage into the abdominal cavity and retroperitoneal space, especially often in the adrenal glands, liver, spleen.
In contrast, idiopathic late hdn is defined as hdn without the presence of any risk factor, such as gastroenteritis or use of antibiotics. It most often develops in the first days and weeks of life. Some diseases are acute, producing severe symptoms that terminate after a short time, e. Hemorrhagic disease of newborn is an important cause of bleeding in an infant. Controversies concerning vitamin k and the newborn american. Bleeding in the newborn is often a serious problem because of cardiovascular effects associated with a loss of blood andor the damaging effects of bleeding on neonatal tissues, especially the brain. Hemorrhagic disease of newborn pdf in the past, the term hemorrhagic disease of the newborn was used to describe bleeding disorders in neonates associated with a traumatic birth. Hemorrhagic disease of the newborn hdn is a coagulation disturbance in newborns due to vitamin k deficiency. Hemorrhagic disease of the newborn medical disorder. Treatment of haemorrhagic disease of the newborn the bmj. The problem of hemorrhage in the newborn has been under study for many years but continues to be a subject of considerable controversy. Hemorrhagic disease of the newborn boston childrens.
Hemorrhagic disease is a bleeding problem that occurs in a baby during the first few days of life. The diagnosis is suggested by an international normalized ratio inr. A deficiency in vitamin k is the main cause of hemorrhagic disease in newborn babies. Vitamin k deficiency bleeding or vkdb formerly known as hemorrhagic disease of the newborn or hdnb is significant bleeding which results from the newborn s inability to sufficiently activate vitamin kdependent coagulation factors because of a relative. Hemolytic disease of the newborn, also known as hemolytic disease of the fetus and newborn, hdn, hdfn, or erythroblastosis foetalis, is an alloimmune condition that develops in a fetus at or around birth, when the igg molecules one of the five main types of antibodies produced by the mother pass through the placenta. Designprospective survey of all possible cases of haemorrhagic disease of the newborn as reported by consultant paediatricians using the monthly notification cards of the british paediatric surveillance unit and a. The efficacy of neonatal vitamin k prophylaxis oral or parenteral in the prevention of early vkdb is firmly established. Vitamin k deficiency is rare in adults, except in syndromes with poor fat absorption, in liver disease, or during treatment with certain anticoagulant drugs, which interfere with vitamin k metabolism.
1471 956 1481 1017 71 1112 143 1125 773 395 364 367 1346 1414 1296 904 742 368 949 1244 698 1493 714 199 586 880 1051 205 818 1402 328 437 221