Vitamin k deficiency of newborn

1. VITAMIN K DEFICIENCY OF
NEWBORN
Mrs.Jagadeeswari.J
M.Sc N

2. DEFINITION
Hemorrhagic disease of
newborn which is also known as
vitamin K deficiency
bleeding(VKDB) is a coagulation
disturbance in newborn due to
vitamin K deficiency.

3. CLASSIFICATIONOF VITAMIN K DEFICIENCY
(depending on onset ofdisease)
•Early onset
•Classic onset
•Late onset

4. ONSET
• Early onset-within first 24
hours.
• Classic onset-after 24 hours till
1 week
• Late onset-2-12 weeks

5. INCIDENCE
•Early onset-very rare
•Classic onset-2%
•Late onset-depending
disease

6. CAUSESOF VITAMINK DEFICIENCYOF
NEWBORN
A moderate decrease of
factors II,VII,IX and X may cause
bleeding by 48-72 hours after
birth which gradual return to
birth levels by 7-10 days of age.

7. CAUSESOF EARLYONSET
• Maternal drugs
(phenobarbitone ,phenytoin
,warfarin , rifampin, isoniazid)
• Inherited coagulopathy

8. CAUSESOF CLASSICONSET
•Vitamin k deficiency
•Breast feeding

9. CAUSES OFLATE ONSET
• Cholelithiasis –mal-absorption of
vitamin k(biliary atresia ,cystic
fibrosis ,hepatitis )
• Warfarin ingestion
• Idiopathic in Asian breast fed
infants.

10. SYMPTOMSOF VITAMIN KDEFICIENCY
• Early onset
–Cephal-hematoma
–Sub-galeal hematoma
–Intra cranial hematoma
–Gastro intestinal bleeding
–Umbilical bleeding
–Intra abdominal

11. SYMPTOMSOF VITAMIN KDEFICIENCY
• Classic onset
– GI bleeding
– ENT bleeding
– Intra cranial bleeding
– Bleeding from circumcision
– Cutaneous bleeding
– Bleeding from injection sites

12. SYMPTOMSOF VITAMIN KDEFICIENCY
• Late onset
– GI bleeding
– Cutaneous bleeding
– ENT bleeding
– Bleeding from injection sites
– Thoracic bleeding

13. DIAGNOSIS
• Forms of vitamin K
–Vitamin K1-Phylloquinone
–Vitamin K2-Menaquinone
–Vitamin K3-Menodione

14. CONT..
• Coagulation profile
– Prothrombin time(PT)
– Partial thromboblastin time(PTT)
– Fibrinogen level
– Platelet count
– INR
• USG(locating bleeding)
• MRI(rare)

15. TREATMENT
• Administration of vitamin K shot at birth-IM or
IV(dosage vitamin K 0.5 to 1 mcg)
• Subcutaneous administration of vitamin K is
given in symptomatic infants than IM
• If the bleeding is persistent immediate blood
transfusion is given –whole blood/fresh
plasma until prothrombin level is increased
• Parenteral supplement is given in case of late
onset of vitamin K deficiency

16. PREVENTIVE MEASURES
• Vitamin k shot at birth
• Vitamin k administration for
pregnant women who takes anti
seizure medications

17. PROGNOSIS
Prognosis is very poor
in case of late onset of
vitamin k deficiency

18. COMPLICATIONS
• Intra cranial hemorrhage
• Retro peritoneal hemorrhage
• Death