Neonates haemorrhage

Haemorrhagic disease of the newborn. Placental transfer of vitamin K is inefflcient so deficiency can occur, resulting in neonatal haemorrhage. 

Many reports of side effects observed in cases of epilepsy relate to cases in which more than one drug was being employed, and in which it is impossible to assess the responsibility of any individual compound for the effects observed. Fatal neonatal haemorrhage following maternal anticonvulsant therapy with metharbital and methsuxi-mide has been recorded with bleeding into the cranial, abdominal, and thoracic cavities (7 ). 

Therapeutically, vitamin K is used in prophylaxis and treatment of deficiency of clotting factor due to dietary deficiency of vitamin K, chronic antimicrobial therapy, malabsorption syndrome, obstructive jaundice, liver diseases such as cirrhosis and hepatitis, in neonates to prevent or treat haemorrhagic disease of new born to counteract the overdosing of oral anticoagulants... 

Cui J, O Shea KS, Purkayastha A et al. (1996) Fatal haemorrhage and incomplete block to embryogenesis in mice lacking coagulation factor V. Nature 384 66-68 Yang TL, Cui J, Taylor JM et al. (2000) Rescue of fatal neonatal hemorrhage in factor V deficient mice by low level transgene expression. Thromb Haemost 83 70-77... 

Connolly AJ, Ishihara H, Kahn ML et al. (1996) Role of the thrombin receptor in development and evidence for a second receptor. Nature 381 516-519 Cui J, O Shea KS, Purkayastha A et al. (1996) Fatal haemorrhage and incomplete block to embryogenesis in mice lacking coagulation factor V. Nature 384 66-68 Denis C, Methia N, Frenette PS et al. (1998) A mouse model of severe von Willebrand disease defects in hemostasis and thrombosis. Proc Nad Acad Sci USA 95 9524-9529 Dewerchin M, Liang Z, Moons L et al. (2000) Blood coagulation factor X deficiency causes partial embryonic lethality and fatal neonatal bleeding in mice. Thromb Haemost 83 185-190... 

Schulte J, Osborne J, Benson JW, Cooke R, Drayton M, Murphy J, Rennie J, Speidel B. Developmental outcome of the use of etamsylate for prevention of periventricular haemorrhage in a randomised controlled trial. Arch Dis Child Fetal Neonatal Ed 2005 90(l) F31-5. 

NSAIDs soon found novel use in many clinical conditions. Patency of the ductus arteriosus in neonates, mastocytosis, dysmenorrhoea and other conditions are often remarkably improved by these drugs. At the same time, many adverse effects of NSAIDs can be interpreted as due to inhibition of prostaglandin synthesis. In gynaecology, for example, NSAIDs were thus found to delay parturition and cause haemorrhagic complications in the mother, and to induce premature closure of the ductus arteriosus in the infant (for reviews see refs. 79 and 80). 

A small number of newborn infants have very low reserves of vitamin K and are at risk of potentially fatal haemorrhagic disease. It is therefore generally recommended that all neonates should be given a single prophylactic dose of vitamin K. 

---