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A prospective study of bleeding neonates: Clinical presentation, aetiological profile, immediate outcome and short term follow up.

Swarnim S, Brajesh kumar Rai, Divya M, Kripanath M

Background and objective: Bleeding in neonates is a significant cause of morbidity and mortality in the neonatal period. The early identification of bleeding and its cause is very important for the appropriate management and for prognostication. The relative paucity of Indian studies on bleeding in newborns prompted us to do this study looking at Clinical Presentation, aetiological Profile, Immediate Outcome, and Short Term Follow up of Bleeding Neonates. Methods: This prospective study was done in NICU of a tertiary care hospital in Bihar, between February 2013 to august 2014. A detailed history, family history, perinatal problems and thorough clinical assessment, relevant investigations were done when required, for all the 70 neonates who had bleeding manifestations out of 1803 admissions, during the same period. Immediate outcome, i.e., survival or death and developmental assessment at 6 months of age in the survivors was done. Results: The incidence of bleeding neonates was 3.88%. Preterm infants had a higher incidence of bleeding 18.57% (p<0.001).Very low birth weight babies had an increased risk of bleeding (p<0.01). Out born babies were at higher risk of bleeding 88% (p<0.01). 71.43% of the neonates had bleeding manifestation between the second and seventh day of life. Disseminated intravascular coagulation constituted the major cause of bleeding (55.7%). Septicemia with DIC contributed 65.22% of cases of death. The outcome of early and classic VKDB was excellent whereas it was dismal for late VKDB. Vitamin K prophylaxis has an important role in the prevention of VKDB.