Hemorrhagic disease of newborn in children's hospital AT Damascus University and medical staff compliance to prophylactic vitamin K administration

Abstract EN

Objective : To determine the morbidity and mortality due to hemorrhagic disease of the newborn HDNB (vitamin K induced hemorrhagic disease) at Damascus University Children's Hospital (DUCH), and degree of medical staff compliance for applying related guidelines.

Methods : A retrospective descriptive study of 307 patients with the diagnosis of HDNB at DUCH during 2000-2009.

Ages ranged between 1 day and three months.

Clinical, hematological and imaging studies were considered in all cases before final diagnosis of HDNB were established.

Results : A specimen of 307 patients were diagnosed having HDNB after the national guidelines for prophylactic vitamin K administration to newborns were established in 2000 by ministry of health.

Early HDNB was found in 5.8 %, classic HDNB in 14.3 % and late HDNB in 78.8 %.

Home delivery contributed 32.9 % of cases where hospital delivery 52.44 % and private clinic delivery in 14.6 %.

Vitamin K injection after delivery was given in 14.2 % (28 of 197) of well documented cases.

Intra cranial hemorrhage was the most common complication especially in the late form of the disease 54.1 %.

Other hemorrhagic complications were as follows : skin 14.9 %, gastrointestinal 18.6 %M and circumcision 8.7 %.

Death occurred in 23 % of cases (n = 71) ; seizures occurred in 10 % of survivors Conclusions : HDNB is still present as a cause of morbidity and mortality in newborn period and early infancy in area of the study; vitamin K administration at delivery is not a routine practice despite of clear national guidelines.