Neonatal bleeding disorders must be diagnosed and coagulation studies interpreted in light of the known neonatal hemostatic deficits. The evaluation should begin with a complete history of family and maternal illness, drug ingestion, and complications during gestation, labor and delivery. Confirmation of vitamin K administration is essential. Physical examination should reveal whether or not the infant is healthy or systemically ill. Bleeding in healthy infants is usually due to vitamin K deficiency, immune-mediated thrombocytopenia, coagulation factor deficits, and local problems secondary to birth trauma. Sick infants are more likely to have bleeding associated with disseminated intravascular coagulation, mechanical consumption of platelets (sepsis, necrotizing enterocolitis, etc.), or hepatic dysfunction. Initial coagulation screen should include platelet count, PT and PTT, with careful attention to potential methodologic errors. Confirmatory tests (thrombin time, fibrin split products, platelet function tests, factor assays, etc.) may be necessary in some cases, but most neonatal bleeding disorders can be readily diagnosed and managed by the outlined approach.
|Original language||English (US)|
|Number of pages||14|
|Journal||Critical Care Quarterly|
|State||Published - Jan 1 1979|
ASJC Scopus subject areas
- Critical Care and Intensive Care Medicine