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Postdelivery head bleeding in hemophilic neonates. Causes and management
M Kletzel1, C H Miller, D L Becton
1Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock 72205.
American Journal of Diseases of Children (1960)
|September 1, 1989
Summary
Head bleeding, including intracranial hemorrhage, may be more common in newborns with hemophilia. Early diagnosis and careful pregnancy management, considering family history and carrier testing, are crucial for preventing birth trauma and ensuring optimal delivery methods.
Area of Science:
- Pediatrics
- Hematology
- Neonatology
Background:
- Hemophilia is a genetic bleeding disorder that affects newborns.
- Head bleeding in neonates with hemophilia requires careful consideration during pregnancy and delivery.
Observation:
- Four out of five infants born in Arkansas with hemophilia experienced head bleeding within a 12-month period.
- Traumatic deliveries, including forceps and vacuum extraction, were noted in three infants.
- Cephalohematoma occurred in a neonate with prenatally diagnosed hemophilia following vaginal delivery.
Findings:
- Central nervous system bleeding may be more prevalent in hemophilic neonates than previously assumed.
- Delayed diagnosis occurred in three infants, even with a family history of hemophilia.
- Prenatal diagnosis in confirmed carriers allows for selection of the least traumatic delivery method.
Implications:
- Pregnancy management should incorporate family history of bleeding disorders and carrier testing.
- Any neonate presenting with intracranial hemorrhage should be evaluated for possible hemophilia.
- Increased awareness and diagnostic vigilance are necessary for improving outcomes in hemophilic neonates.