Vitamin K deficiency bleeding and early infant male circumcision in Africa.

Abstract

BACKGROUND:

Early infant (1-60 days of life) male circumcision is being trialed in Africa as a human immunodeficiency virus prevention strategy. Postcircumcision bleeding is particularly concerning where most infants are breastfed, and thus these infants are at increased risk of vitamin K deficiency bleeding.

CASE:

During a circumcision trial, one infant bled for 90 minutes postprocedure. After discovering he had not received standard prophylactic vitamin K, we gave 2 mg phytomenadione (vitamin K1) intramuscularly; bleeding stopped within 30 minutes.

CONCLUSION:

Vitamin K's extremely rapid action is not commonly appreciated. Neonatal vitamin K has been shown to be cost-effective. To increase availability and promote awareness of its importance, especially in low-resource settings where blood products and transfusions are limited, vitamin K should be included in the World Health Organization's Model List of Essential Medicines for Children.

• Authors: Rebeca M Plank, Tara Steinmetz, David C Sokal, Martin J Shearer, Santorino Data
• Journal: Obstetrics and gynecology (Obstet Gynecol) Vol. 122 Issue 2 Pt 2 Pg. 503-505 (Aug 2013) ISSN: 1873-233X [Electronic] United States
• PMID: 23884276 (Publication Type: Case Reports, Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)

Chemical References

• Vitamins
• Vitamin K 1

Topics

• Africa
• Circumcision, Male (adverse effects)
• Hemorrhage (drug therapy, etiology, prevention & control)
• Humans
• Infant, Newborn
• Male
• Vitamin K 1 (therapeutic use)
• Vitamin K Deficiency (complications)
• Vitamins (therapeutic use)