Hemorrhagic disease prevention in newborns
Section: Revisions
Authors
Patricia Álvarez Holgado
Position
Enfermera Especialista en Obstetricia y Ginecología. Hospital Quironsalud Campo de Gibraltar.
Contact email: patricia.alvarezholgado@gmail.com
Abstract
Neonatal hemorrhagic disease (NHD) is an acquired coagulation disorder secondary to a deficiency in vitamin K-dependent coagulation factors (II, VII, IX, and X). Clinical signs include intracranial, skin, gastrointestinal, and nasal bleeding, as well as bleeding secondary to circumcision or invasive procedures. Two different forms exist: classical or early, appearing in the first week of life; and late, developing from 2 weeks to 6 months after birth.
Purpose: to assess predisposing factors to NHD and, particularly, to find out potential modifiable factors; and to show the efficacy and safety of prophylactic therapy for NHD.
Methods: a literature search was carried out by means of BVSSPA and data were obtained from CochranePlus, PubMed and Uptodate Database. Protocols by the Sociedad Española de Pediatría were reviewed.
Results: valid data to assess modifiable predisposing factors for NHE were found: lack of use of prophylactic vitamin K within six hours after birth and exclusive breastfeeding versus formula.
Conclusions: use of prophylactic vitamin K (phytomenadione) after birth has proved effective in controlling NHD. Vitamin K should be administered intramuscularly or orally. Oral use can be effective, but safety is lower due to the inclusion of independent factors needed for such use. Intramuscular administration can be recommended due to its better results in NHD prevention. A relationship between intramuscular administration and solid tumor development has been ruled out.
Keywords:
hemorrhagic disease; newborn; predisposing factorsmodifiable factors
Versión en Español
Título:
Artículo completo no disponible en este idioma / Full article is not available in this language
Bibliography
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