Professional paper
NEONATAL DEATH OF THE MOTHER TREATED BY METHYLPHENOBARBITONE DUE TO EARLY MASSIVE PULMONARY HAEMORRHAGE PROBABLY CAUSED BY VITAMIN K DEFICIENCY
Anija Matičević
Hrvojka Vranješ
Tomislav Ivičević Bakulić
Ahmed Pirkić
Abstract
A case of a very mature well-developed newborn which manifested massive pulmonary hemorrhage immediately after birth is presented. The hemorrhage repeated within 8 hours and the child died. The hemorrhage was probably caused by a vitamin K deficit due to the fact that his epileptic mother had been treated with methylphenobarbitone (Phemiton) during pregnancy. She had kept it secret during pregnancy and on admission to maternity hospital. Considering the rapid course of events and massive hemorrhage, a coagulopathy was not discovered, but as the bleeding stopped immediately following birth after vitamin K had been administered it can be a sign of its deficit. Not before the newborn’s death did we learn from the mother that for four years she had been treated with methylphenobarbitone taking a 400 mg dosage daily. It is well-known that the anti-epileptic drug treatment can, in newborns, cause a secondary early form of hemorrhagic disease, which can be manifested intracranially, intrathoracally, intra-abdominally and as a bleeding at the place of scalp electrode insertion. Pulmonary hemorrhage, like in our patient, appears exceptionally rarely. In order to prevent an early hemorrhage disease in pregnancy it is important to administer vitamin K to mother from 36th week onward, and to make coagulation tests immediately after birth. The child must be then cared for accordingly either by vitamin K or fresh frozen plasma administration.
Keywords
pulmonary hemorrhage; early hemorrhagic disease in newborn; methylphenobarbitone; vitamin K deficit
Hrčak ID:
15545
URI
Publication date:
1.12.2003.
Visits: 2.533 *