Symptoms of hemorrhagic disease of the newborn
The early form of hemorrhagic disease of a newborn is characterized by the appearance in the first days of life of bloody vomiting (haematomesis), pulmonary hemorrhage, hemorrhage into the abdominal cavity and retroperitoneal space, especially often in the adrenal glands, liver, spleen. Hemorrhagic disease of a newborn can begin even in utero, and the child already at birth has intracranial hemorrhages (with neurosonography), cutaneous hemorrhages.
The classical form of hemorrhagic disease is typical for a child on natural feeding and appears on the 3-5th day of life with bloody vomiting, melena (intestinal bleeding), skin hemorrhages (ecchymoses, petechiae), bleeding when the remainder of the umbilical cord, cephalohematoma. In children with severe hypoxia, birth trauma, vitamin K deficiency can be manifested in the form of intracranial hemorrhages, hemorrhages for aponeurosis, as well as internal hematomas and bleeding.
Children with melena may have hyperbilirubinemia due to increased disintegration of erythrocytes in the intestine. The cause of melena is the formation of small ulcers on the mucous membrane of the stomach and duodenum, in the genesis of which the leading role is taken of the excess in the newborn glucocorticoids (due to the birth stress), ischemia of the stomach and intestine. A certain role in the origin of melena and bloody vomiting is played by gastroesophageal reflux and peptic esophagitis.
Clinical symptoms of late hemorrhagic disease of the newborn can be: intracranial hemorrhage (more than 50%), extensive skin ecchymosis, melena, hematemesis, umbilical cord bleeding, hematuria, cephalohematoma.
Complications of hemorrhagic disease of newborns include hypovolemic shock, which is manifested by weakness, pallor, often a drop in body temperature to subnormal figures, a drop in blood pressure.