HAEMORRHAGIC DISEASE OF THE NEWBORN

 HAEMORRHAGIC DISEASE OF THE NEWBORN

This bleeding occurs during the first fews days of life due  tovitasmin K deficiency. Vitamin K is synthesized by the bowel normal flora and its role is to convert clotting factors such as prothombin, thrombokinase, thromboplastin. To prevent HDN the neonates are given vitamin K 0.5-1 mgi.m.

 predisposing factors

· Hereditary factors- clotting factor defect e.g. haemophilia

· Prematurity

· Birth trauma

· Treatment with antibiotics

· Respiratory distress syndrome

· Disseminated intravascular coagulopathy (DIC)

· Birth asphyxia

· Mothers who are on drug such as warfarin, heparin and Phenobarbital

Clinical features

· Continuous oozing of blood from the umbilical cord

· There is a spontaneous bleeding from various parts of the body

· Bleeding in the mucous membrane of GIT and may present with maleana stool or haematemesis

· Continuous bleeding from any punctured blood vessel or injection site thus when looking for venous access avoid puncturing femoral or jugular veins which are the largest veins in the body

· Haematuria or omphalorrhagia

 Nursing management

· Upon admission into NBU, administer vitamin K 0.5-1 mg i.m

· Preserve all linen soiled by blood for estimination of blood loss

· Administer vitamin K 1-2 mg to arrest bleeding immediately

· Observe vital signs TPR ¼ hrly

· If bleeding is severe, transfuse fresh blood or frozen plasma at 20mls/kg of body weight

· Obnserve for signs of shock and if present transfuse with packed cells and fresh whole blood at 75 -100mls/kg of body weight if the baby is term

· General management is like any other baby in the unit

Complications

· Anaemia

· Hypovolaemic shock

· Brain damage