Hemorrhagic disease of the newborn caused by vitamin K deficiency

Czech version

Authors: Fiamoli Veronika; Blatný Jan
Authors‘ workplace: Oddělení dětské hematologie a biochemie, Lékařská fakulta Masarykovy univerzity a Fakultní nemocnice Brno
Published in: Čes-slov Pediat 2022; 77 (5): 303-305.
Category: Chapters for Specialization in Pediatrics
doi: https://doi.org/10.55095/CSPediatrie2022/049

Overview

Hemorrhagic disease of a newborn is manifested by unexpected bleeding mostly in otherwise healthy newborns and infants and is caused by vitamin K deficiency, which leads to insufficient activity of vitamin K-dependent coagulation factors. The cause is the low level of vitamin K in breast milk and the insufficient synthesis of vitamin K by the neonatal bifid intestinal microflora. There are three forms of this disease, early-onset (0-24 hours), classic (2-7 days) and late-onset (2-12 weeks). Risk of severe intracranial bleeding is typical for the early and late forms, with up to 50% mortality in the late form. The diagnostic standard is the examination of the prothrombin time greater than 4 times the normal values in the presence of a normal level of platelets and fibrinogen. The treatment of an already developed disease is vitamin K, in severe cases also fresh frozen plasma (in children optimally Octaplas®). Since the sixties of the 20th century, the prophylactic administration of vitamin K has been recommended worldwide. As a part of the differential diagnosis in newborns with intracranial bleeding, it is always necessary to rule out trauma, hereditary bleeding disorders such as hemophilia, but also thrombocytopathy or thrombocytopenia.

Keywords:

vitamin K – Prophylaxis – newborn – hemorrhagic disease

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