Approach to the management of a bleeding neonate

Nigerian Journal of Medicine : Journal of the National Association of Resident Doctors of Nigeria
M M Ogundeyi, T A Ogunlesi

Abstract

Neonatal bleeding disorders are common in clinical practice but the laboratory tests required for making the diagnoses are often sophisticated, expensive and so, largely unavailable in the developing world. Thus, a simple clinical approach to the diagnoses and management of neonatal bleeding is desirable in the developing world. A review of literature was done using Medline search, texts on the topic were reviewed. The treatment modalities for each of the common causes of neonatal bleed as well as the limitations encountered in the developing world are also highlighted. Various methods are available for the evaluation of the bleeding neonate, clinical and laboratory with variable sensitivity. For ease of diagnosis in the face of limited laboratory facilities, bleeding babies can be divided into two broad groups: well babies with and without thrombocytopaenia as well as sick babies with and without thrombocytopaenia. Using the parameters like the platelets count, prothrombin time, partial thromboplastin time, assays of fibrin degradation products and the clinical condition of the newborns, a large number of commonly encountered causes of neonatal bleeding disorders can be diagnosed to a fair extent.

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