Clinical profile and follow up of bleeding neonate

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Author: 
Arutsivasakthi siva S, Ramesh S, Saravanan S and Vinoth

Background and Objective: Neonatal hemorrhage either localized or generalized has significant morbidity and mortality. The identification of the cause of bleeding is o paramount importance for the appropriate management and for prognostication. The paucity of Indian studies on bleeding in newborns prompted us to do this study looking at aetiological factors, clinical features and the outcome.

Methods: This prospective study was done in NICU and Referral newborn, Department of pediatrics, RMMC&H, Chidambaram, between October 2014 and September 2015. A detailedhistory, family history, perinatal problems and thorough clinical assessment , relevant investigation were done when required, for all the 50 neonates who had bleeding Investigations were done when required, for all the 50 neonates who had bleeding i.e., Survival or death and developmentalassessment at 6 months of age in the survivors was done.

Results: The incidence of bleeding in neonates was 5.2% preterm babies(68%) and outborn babies (84%) had statitically significant risk of bleeding. 88% of neonates had bleeding, 88 % of neonates had bleeding in the first week of life. Dic constituted. 88% of neonates had bleeding in the first week of life, DIC constituted the major cause for bleeding (66%) and VKDB constituted 18%. Nearly 2/3rd cases of VKDB were classic VKDB.8.2% of NICU and referral newborn unit deaths were in the neonates withbleeding. Bleeding constituted a significant risk factor for morality in NICU. Out of 36 survivors, 28 cases were normal in neurodevelopment and physical outcome, 5 cases were lost for followup and development delay was noted in 2 cases.

Interpretation and conclusion: Preterm ,IUGR, outborn babies, sick neonates have higher incidence of bleeding. Bleeding is more common in the first week of life. Late VKDB has bad prognosis. Vitamin K prophylaxis has an important role in the prevention of VKDB.

Page: 
51-55
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