Approach to the bleeding newborn

Abstract

Bleeding in the newborn can lead to serious cardiovascular and neurological effects. Routine administration of vitamin K has reduced the incidence of hemorrhagic disease of the newborn, but abnormal bleeding can occur in babies from many causes. A practical approach to the diagnosis and treatment of bleeding in the newborn is described in this article.

Canadian Paediatric Surveillance Program confirms low incidence of hemorrhagic disease of the newborn in Canada

“…Although an article on an approach to the bleeding newborn was published in Paediatrics & Child Health at the end of 1998 (23), and the definition for HDNB was provided in the CPSP protocol sent to all participants at the start of the study, physicians may have relied on a variety of different published educational resources to determine investigations for diagnosing causes of bleeding in the newborn. During the study period, there were reports of infants who did not have coagulation tests and of infants with other bleeding etiologies.…”

Placental abruption leading to disseminated intravascular coagulation and massive subgaleal hematoma in the newborn

“…The increase in D-dimer can be detected in preterm infants [9]. Measuring factor VIII may help distinguish DIC from liver dysfunction, although factor VIII may also be congenitally deficient [10]. A combination of coagulation disorders with cerebral and subgaleal hemorrhage with respiratory distress syndrome as a manifestation of venous infarcts of lungs and liver would have made a specific clinical DIC syndrome diagnosis in our case.…”

Assessment of Safety in Newborns of Mothers Participating in Clinical Trials of Vaccines Administered During Pregnancy

“…should be included to support the diagnosis of conditions detected before birth and assist with attribution assessments of events identified after birth. Table 1 [20][21][22][24][25][26][27][28][29][30] provides definitions and grading of infant events recommended for evaluation of infants in clinical trials of maternal vaccines.…”