Mubarak Ali, Mohammed Yar, Attaullah Mazhar.
Clinical profile and risk factors in late haemorrhagic disease of newborn: our experience.
J Sheikh Zayed Med Coll Jan ;1(1):11-5.

Background: Haemorrhagic disease of the newborn (HDN) is not an uncommon entity in developing countries particularly in under previleged rural areas like southern punjab, where the prophylactic administration of vitamin-K at birth is not routinely practiced. The commonest mode of presentation of late HDN is intracranial hemorrhage. Objective: The present study was conducted to assess the clinical profile and risk factors of patients with Late (HDN). Patients and Methods: All infants above the age of 7 days were admitted in pediatric unit with vitamin K deficiency bleeding. An infant fulfilling the criteria of late HDN was included in the study.Infants with clinical and laboratory evidence of liver disease were excluded from the study. In these selected infants a detailed history, physical examination and investigations were carried out with special emphasis on risk factors for vitamin K deficiency and clinical features secondary to bleeding. Vitamin K 5 mg intravenous was given to all the patients and investigations were repeated after 24 hours. Results: Thirty two infants fulfilled the criteria of late HDN; 24 (75%) were males and 8 (25%) females. Majority of the babies (75%) were in the age group 4 to 12 weeks. Prophylactic Vitamin K was not given to any of the infants at birth or later. All were on exclusive breastfeeding, two had history of prolonged diarrhea and two had received antibiotics for one week. Majority of the infants 24 (75%) presented with neurological features i.e. convulsions 62%, altered sensorium 56%. Purpura and bleeding from other orifices were less frequent i.e. <10%. Six (18.75%) infants died. Conclusion: Intracranial hemorrhage is the commonest mode of presentation of late HDN and carries significant morbidity and mortality. Hence, vitamin K prophylaxis at birth is a deadly desirable intervention to avoid this potentially preventable life threatening condition.

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