Diagnosis and treatment of coagulopathy in the newborn

Appropriate management of the bleeding newborn is easily accomplished by first assessing the clinical circumstances under which the bleeding occurs. Having determined the clinical circumstances, knowledge of the pathophysiology of disseminated intravascular coagulation, liver failure, vitamin K deficiency, and hemophilia coupled with knowledge of the normal levels of coagulation factor activities at birth leads to selection of appropriate laboratory tests to confirm the etiology of the bleeding. Once the etiology is confirmed, treatment requires management of associated clinical conditions and replacement of vitamin K and/or deficient coagulation factors.