Vitamin K Deficiency

Phytomenadione or vitamin K1 plays a vital role in the production of vitamin K dependent coagulation factors, including factors II (prothrombin), VII, IX and X, and proteins C and S.

Vitamin K is found in green leafy vegetables and oils (soyabean, canola) and is synthesized by colonic bacteria.

Deficiency is frequent in newborns due to

  • poor transmission of vitamin K across the placenta.
  • paucity in breast milk, lack of gut bacteria and prematurity of liver function.
  • Vitamin K deficiency may follow prolonged antibiotic use, parenchymal liver disease, prolonged total parenteral nutrition and malabsorption.
  • The prevalence of late vitamin K deficiency bleeding in breastfed infants not given prophylaxis is 20 cases per 100,000 live births.
  • Deficiency of vitamin K dependent factors leads to prolonged prothrombin and activated partial thromboplastin time.

Vitamin K is administered as a single subcutaneous dose of 1 mg at birth to prevent hemorrhagic disease of the newborn. Prophylaxis with vitamin K is widely practiced and safe. Larger doses of vitamin K (210 mg) can be given to treat symptomatic neonates who did not receive prophylaxis or have anticoagulant overdose; this is repeated till coagulation studies are normal. Fresh frozen plasma is administered if there is overt bleeding, or liver dysfunction is suspected.

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