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Prothrombin time in first week of life with special reference to vitamin K administration
G P Mathur1, S Mathur, R Goenka
1Department of Pediatrics, GSVM Medical College, Kanpur.
Insights
Vitamin K supplementation is crucial for newborns experiencing birth hypoxia or prematurity, as it significantly improves prothrombin time. Healthy, full-term infants do not require this intervention.
Area of Science:
- Neonatal Medicine
- Pediatric Hematology
Background:
- Prothrombin time (PT) is a critical measure of blood coagulation.
- Neonatal hemostasis differs from adults, with lower levels of vitamin K-dependent clotting factors.
- Prematurity and birth complications like hypoxia can exacerbate coagulation disturbances in newborns.
Purpose of the Study:
- To assess prothrombin time in a cohort of neonates.
- To determine the impact of prematurity and birth hypoxia on prothrombin time.
- To evaluate the efficacy of Vitamin K administration in correcting altered prothrombin times.
Main Methods:
- Prothrombin time was measured in 100 neonates (80 full-term, 20 preterm).
- Subgroups included healthy and sick full-term infants.
- Vitamin K was administered to anoxic neonates, and prothrombin time was re-evaluated.
Main Results:
- Prothrombin time was significantly altered in neonates with birth hypoxia and prematurity (p < 0.001).
- Vitamin K administration led to significant improvement in prothrombin time within 48-72 hours in anoxic neonates (p < 0.001).
- Bleeding complications occurred in four newborns, primarily in preterm infants who did not receive Vitamin K.
Conclusions:
- Vitamin K is recommended for all preterm infants and those experiencing difficult deliveries.
- Routine Vitamin K administration is not necessary for healthy, full-term newborns.
- Prompt Vitamin K supplementation can prevent bleeding complications in at-risk neonates.
Abstract:
Prothrombin time was estimated in 100 neonates (80 full term and 20 preterm). Among the full term infants 50 were healthy and 30 sick. Prothrombin time was altered in neonates with birth hypoxia and prematurity (p less than 0.001). Vitamin K administration to anoxic babies resulted in improvement in prothrombin time after 48-72 hours (p less than 0.001). Four newborns has bleeding, 2 had anoxia and 2 were only in preterms who did not receive vitamin K after birth. It is concluded that vitamin K should be given to all preterms and those with difficult deliveries; term, healthy newborns do not need it.