Vitamin K Deficiency Bleeding and Early Infant Male Circumcision in Africa
Published Date:Aug 2013
Source:Obstet Gynecol. 2013; 122(2 0 2):503-505.
Pubmed Central ID:PMC3773869
Funding:K23 AI084579/AI/NIAID NIH HHS/United States
U2G PS000941/PS/NCHHSTP CDC HHS/United States
5K23AI084579/AI/NIAID NIH HHS/United States
U2GPS000941-01/PHS HHS/United States
Early infant (1–60 days of life) male circumcision is being trialed in Africa as a human immuno-deficiency 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.
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.
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.
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