We evaluated late-appearing intracranial hemorrhages due to vitamin K deficiency in newborns, together with treatment and results.
STUDY DESIGN
The study included nine newborns (age range 12 to 58 days) in whom late-appearing intracranial hemorrhage was detected due to vitamin K deficiency following anormal delivery. All were receiving only breast milk. None of them had any systemic pathology or a history of trauma. The patients were followed-up for a mean of six months.
RESULTS
Eight newborns had not received vitamin K prophylaxis. Intracranial hemorrhages were either alone or in combination and included subarachnoid hemorrhage (n=7), subdural hemorrhage (n=3), intraparenchymal hemorrhage (n=3), and intraventricular hemorrhage (n=l). Four patients manifested an International Normalized Ratio (INR) of more than 3, with a prolonged prothrombin time and partial thromboplastin time. Treatment was designed as 1-5 mg of intravenous vitamin K. One patient required surgical drainage. One patient died due to extensive subarachnoid hemorrhage. No clinical deterioration, increase in the size of the hemorrhages, or complications occurred in the remaining patients.
CONCLUSION
The need for vitamin K prophylaxis is emphasized especially for exclusively breast-fed newboms. However, it should be borne in mind that insufficient doses of vitamin K may fail to prevent late-appearing intracranial hemorrhages.