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Thrombotest for Coagulation Studies in the Newborn and Vitamin K Prophylaxis.

Journal of the Korean Pediatric Society 1965;8(2):43-50.
Published online May 31, 1965.
Thrombotest for Coagulation Studies in the Newborn and Vitamin K Prophylaxis.
Kir Young Kim, Kook Hoon Ko, Chong Moo Lee, J.Courtland Robinson
Depts, of Pediatrics, Clinical Pathology and Obstetrics and Genecology. Yonsei University, Medical School
Thrombotest에 依한 新生兒出血增과 그 豫防에 對한 觀察
金吉英, 高 克勳, 李鍾武,
延世大學校훌훌科大學 小兒科學敎室.臨皮病理學敎. 産婦人科學敎室
Hemorrhagic disorder of the newborn infant was fist described in 1894 by Dr. Townsend. Since then the etiology, therapy and prophylaxis pave aroused great interest. The object of the present work has been to investigate the risk of hemorrhage in newborn infants and the possible need for vitamin K prophylaxis. In the newborn period, numerous investigators were able to demonstrate a temporary depression of the coagulation factors, which include prothrombin, proconvertin, plasma thromboplastin component and StuartPrower factor. The thrombotest, which detects the reduction of the four factors mentioned above, was utilized to determine the coagulability of the blood of newborn babies who recsived a vitamin K preparation. According to this method, a risk of hemorrhage is believed to occur when the thrombotest percentage (T.T%) is below 10. We have used “Menadione Sodium Bisulfite” from the Vitamin K preparations, because it is much less expensive and used widely in general clinic. One hundred and forty four healthy full-term newborns and fourteen premature babies have been investigated. The subjects were divided into 6 groups; Group I. consisted of 45 newborn infants who did not receive vitamin K after birth. (Fig 4) Group II. consisted of 34 newborn infants who received 2 mg of Menadione sodium bisulfite intramuscularly immediately after birth. (Fig 5) Group 111. consisted of 35 infants whose mothers had received 10 mg of Menadione sodium bisulfite intramuscularly 4 to 24 hours before delivery. (Fig 6) Group IV. consisted of 15 infants who received 5 oral Menadione sodium bisulfite immediatelyafter birth. (Fig7) Group V. consisted of 15 infants whose mothers had received 20 mg oral Menadione sodium bisulfite 4 to 24 hours before delivery. (Fig 8) Group VI. consisted of 14 premature babies who did not received Vitamin K after birth. Their weights were between 1780 gm to 2500 gm. (Fig 9) Using a new method of Thrombotest, we found in these groups that coagulation defect on 2 nd and 3 rd day of life is so great as to constitute a risk of hem orrhage. These phenomena could be prevented in groups of administering Meoadione sodium bisulfite (Vit. K3) (Group 11, 111, IV & V), especially to the mother 4 to 24 hours prior to delivery, either orally or intramuscularly. (Group 111& V) In premature group, the majority averaged 77% are low to compare with control group. The risk of jaundice in the newborn infants who received Vit. K3 cr whose mothers had received Vit. K3, was also investigated, and showed that a single dose of Menadione sodium bisulfite did not cause hyperbilirubinemia. (Table 1) From the above findings, it is concluded that Vitamin K prophylaxis is repuired by all newborn babies in order to prevent hemorrhagic disorders during the 2 nd and 3 rd day of life.

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