L10: Bleeding Disorders in Newborn

Question 1

Causes of Bleeding in Newborn

Answer 1

Question 2

Incidence of Hemorrhagic Disease of the Newborn

Answer 2

• 1/200 - 400 babies not given vitamin K prophylaxis.
• The most common cause of bleeding in newborns.

Question 3

Etiology of Hemorrhagic Disease of the Newborn

Answer 3

Deficiency of vitamin K dependent coagulation factors II, VII, IX, and X.

Question 4

Pathogenesis of Hemorrhagic Disease of the Newborn

Answer 4

Question 5

CP of Hemorrhagic Disease of the Newborn

Answer 5

Question 6

CP of Hemorrhagic Disease of the Newborn

• Early Form

Answer 6

Question 7

CP of Hemorrhagic Disease of the Newborn

• Classic Form

Answer 7

Question 8

CP of Hemorrhagic Disease of the Newborn

• Late Form

Answer 8

Question 9

INVx for Hemorrhagic Disease of the Newborn

Answer 9

Question 10

Management of Hemorrhagic Disease of the Newborn

Answer 10

Question 11

Management of Hemorrhagic Disease of the Newborn

• Prophylactic

Answer 11

• Early feeding
• Vitamin K (1 mg) at the time of delivery

Question 12

Management of Hemorrhagic Disease of the Newborn

• Therapeutic

Answer 12

• Vitamin K (5 mg IV or IM).
• Fresh frozen Plasma or fresh blood transfusion especially in severe hemorrhage”

Question 13

Etiology of DIC in Newborn

Answer 13

Question 14

Pathogenesis of DIC in Newborn

Answer 14

Question 15

CP of DIC in Newborn

Answer 15

The baby is usually in bad general health (i.e., not active).

Question 16

INVx for DIC in Newborn

Answer 16

Question 17

TTT of DIC in Newborn

Answer 17

• TTT of the cause
• Supportive care: platelet transfusions, FFP & Cryoprecipitate “to control bleeding”.

Question 18

Prognosis of DIC in Newborn

Answer 18

Poor

Question 19

Def of Thrombocytopenia in Newborn

Answer 19

PLT count < 150.000/mm3

Question 20

Etiology of Thrombocytopenia in Newborn

Answer 20

Question 21

Etiology of Thromboasthenia in Newborn

Answer 21

• Inherited (e.g., Glanzman disease).
• Platelet dysfunction (due to maternal drugs e.g., aspirin)

Question 22

Etiology of IFD in Newborn

Answer 22

• Congenital afibrinogenemia. (Factor 1)
• Factor VIII deficiency.

Question 23

Causes of Traumatic Bleeding in Newborn

Answer 23

Birth injuries lead to:

• Rupture of liver & spleen in breech delivery
• Subdural hematoma
• Cephalhematoma
• Subgaleal hemorrhage

Question 24

Algorithm in Bleeding Disorders in Newborn

Answer 24

Question 25

INVx for Bleeding Disorders in Newborn

Answer 25

Question 26

INVx for Bleeding Disorders in Newborn

• Traumatic (Localized)

Answer 26

Question 27

INVx for Bleeding Disorders in Newborn

• Vit K Deficiency

Answer 27

Question 28

INVx for Bleeding Disorders in Newborn

• Thrombcytopenia

Answer 28

Question 29

INVx for Bleeding Disorders in Newborn

• Hemophilia

Answer 29

Question 30

INVx for Bleeding Disorders in Newborn

• DIC

Answer 30

Question 31

INVx for Bleeding Disorders in Newborn

• Liver Diseases

Answer 31

Question 32

INVx for Bleeding Disorders in Newborn

• Infection

Answer 32

Question 33

Normal

• PT
• APTT
• Bleeding Time
• Clotting Time

Answer 33

Question 34

TTT of Neonatal Bleeding

Answer 34

Question 35

TTT of Neonatal Bleeding

• Vit K

Answer 35

5mg

Question 36

TTT of Neonatal Bleeding

• FFP

Answer 36

10 ml/kg for active bleeding to replace the clotting factors

Question 37

TTT of Neonatal Bleeding

• Platelet Transfusion

Answer 37

5-10ml/kg could raise platelet count by 10.000 PL./mm3

Question 38

TTT of Neonatal Bleeding

• Fresh Whole Blood

Answer 38

10-20 ml/kg if there is severe anemia or severe Hge