HEMORRHAGIC-DISEASE IN NEWBORN AND OLDER INFANTS - A STUDY IN HOSPITALIZED CHILDREN IN KELANTAN, MALAYSIA

This is a retrospective study of the epidemiology, clinical features, laboratory findings, treatment and outcome of haemorrhagic disease in 42 Kelantanese infants who were admitted to Hospital Universiti Sains Malaysia during a 2-year period (1987-1988). Classical haemorrhagic di sease of the newborn was the commonest presentation (48%), followed by early onset (29%) and late onset (24%) disease. Home deliveries accou nted for 81% of the affected infants. Most of these babies were not gi ven vitamin K at birth in contrast to those delivered in hospitals. Al l except one infant were breastfed. The six commonest presenting clini cal features were pallor, jaundice, umbilical cord bleeding, tense fon tanelle, convulsions and hepatomegaly. All the infants had prolonged p rothrombin and partial thromboplastin times which were corrected by ad ministration of vitamin K. Subdural haemorrhage was the commonest form of intracranial haemorrhage, followed by subarachnoid haemorrhage. Th e overall case fatality rate was 14%. The results of this study once a gain emphasize the value of vitamin K prophylaxis in the newborn.