Cause of hemorrhagic disease of newborn bleed on the 2nd day of birth, which of the following clotting factors maybe involved ?
Ans. is 'a' i.e., 2, 7, 9, 10 o Hemorrhagic disease of the newborn A moderate decrease in factors II, VII, IX, and X normally occurs in all newborn infants by 48-72 hr after birth, with a gradual return to birth levels by 7-10 days of age. This transient deficiency of vitamin K-dependent factors is probably due to lack of free vitamin K from the mother and absence of the bacterial intestinal flora normally responsible for the synthesis of vitamin K. EARLY ONSET CLASSIC DISEASE LATE ONSET Age 0-24 hr 2-7 days 1-6 mo Site of hemorrhage Cephalohematoma Subgaleal Intracranial Gastrointestinal Umbilicus Intra-abdominal Gastrointestinal Ear-nose-throat-mucosal Intracranial Circumcision Cutaneous Gastrointestinal Injection sites Intracranial Gastrointestinal Cutaneous Ear-nose-throat-mucosal Injection sites Thoracic Etiology/risks Maternal drugs (phenobarbitaf, phenytoin, warfarin, rifampin, isoniazid) that interfere with vitamin K Vitamin K deficiency Cholestasis-malabsorption of vitamin K (biliary- atresia, cystic fibrosis, hepatitis) Inherited coagulopathy Breast-feeding Abetalipoprotein deficiency Idiopathic in Asian breast-fed infants Warfarin ingestion Prevention Posible vitamin K at birth or to mother (20 mg) before birth Prevented by parenteral vitamin K at birth. Oral vitamin K regimens require repeated dosing over time Prevented by parenteral and high-dose oral vitamin K during periods of malabsorption or cholestasis Avoid high-risk medications
2,7,9,10
3,7,9,10
2,8,9,10
2,5,9,10