DOI: 10.21276/sajb.2016.4.8.13 671 Scholars Academic Journal of Biosciences (SAJB) ISSN 2321-6883 (Online) Sch. Acad. J. Biosci., 2016; 4(8):671-675 ISSN 2347-9515 (Print) ©Scholars Academic and Scientific Publisher (An International Publisher for Academic and Scientific Resources) www.saspublisher.com Study on clinical presentations, risk factors and short term outcome of hemorrhagic disease of newborn Dr Khurshida Khan 1 , Dr Manisha Garg 2 , Dr S.D. Sharma 3 , Dr Priyanshu Mathur 4 , Dr Anika Agarwal 5 1,2 Senior resident, 3 Ex. Head of Department , 4 Assistant professor, 5 Resident, Department of Paediatrics, SMS medical college, Jaipur, Rajasthan, India *Corresponding author Dr. Khurshida Khan Email: dr.khurshidakhan@gmail.com Abstract: Haemorrhagic Disease of Newborn (HDN), also called vitamin K deficiency bleeding (VKDB), is an acquired coagulopathy secondary to reduction of vitamin K dependent coagulation factors below hemostatic levels. It is a preventable disease with prophylactic administration of vitamin K at birth. Aim of this study was to identify clinical presentations, risk factors and short term outcome of infants with hemolytic disease of newborn. A total of 62 patients with hemorrhagic disease of newborn (aged from birth to 6 month) randomly selected to participate in this cross sectional analytical study. In this study 13% babies presented as early HDN, 35% presented as classical HDN and 51% as late HDN In this study, 87% babies were on exclusive breast feeding. The high incidence of HDN in breast-fed babies is due to its low content of vitamin K. Vitamin k was not given in home delivered babies illustrates that traditional birth attendants are unaware about the importance of administration of vitamin K at birth. The most common presentation of HDN was intracranial haemorrhage noted in 41.9% of cases. In this study, majority of babies (87.09%) recovered and discharged. This shows that HDN has good prognosis when adequately treated and not associated with intracranial haemorrhage. Keywords: Vitamin k deficiency ,hemorrhagic disease of newborn ,intracranial hemorrhage. INTRODUCTION The term ‘hemorrhagic disease of newborn’ was first used in 1894 by Charles Townsend [1]. He reported a series of breast-fed infants who presented with self limiting bleeding, usually from gastrointestinal tract, on the second or third day of life with subsequently normal hemostasis in the survivors [2]. Hemorrhagic disease of new born also called vitamin K deficiency bleeding (VKDB), is the name given to the occurrence of spontaneous bleeding in early days of life [2] .Bleeding can occur from birth up to six months of life [3]. Haemorrhagic disease of newborn is more common in certain group of babies like breast-fed infants, preterm babies, malabsorption, cystic fibrosis and neonatal cholestasis etc[4].Late onset disease occurs primarily in exclusively breast-fed infants and is associated with intracranial hemorrhage in about 50% of the cases[1].There are a number of factors which contribute to a transient reduction in the availability of vitamin K to the infant in the newborn period: reduced stores of vitamin K , absence of the bacterial flora which normally synthesize vitamin K ,functional immaturity of the liver (where the vitamin- K- dependent factors are synthesized). Vitamin K facilitates the post-transcription gamma carboxylation of glutamic acid residues on Factors II, VII, IX, and X [5]. In premature infants, the degree and duration of factor deficiency may increase resulting in a more severe and prolonged bleeding tendency [5]. Incidence of vitamin K deficiency bleeding in babies not receiving vitamin K at birth is 0.25% to 1.7%. in united state[6] .Late vitamin K deficiency bleeding has fallen from 4.4-7.2 cases per 100,000 births to 1.4-6.4 cases per 100,000 births in reports from Asia and Europe after regimens for prophylaxis were instituted [7-9]. The disease is classified according to the age of onset; Early (first 24 hours of life), Classic (2-7 days of life) and Late onset (8 days to 6 months of life) disease [4]. Outcome of HDN depends upon type of HDN, site and severity of bleeding, and presence or absence of underlying risk factors. In the absence of intracranial hemorrhage, prognosis is good [1] .So HDN is an important cause of mortality and morbidity in developing countries where vitamin K prophylaxis is Original Research Article