Vitamin K deficiency bleeding

Bleeding due to deficiency of vitamin-K-dependent clotting factors (II, VII, IX, X) in newborns without Konakion prophylaxis in the first hours of life, in patients on prolonged antibiotic therapy, with severe malabsorption, cholestasis or hepatic failure. In unsupplemented newborns intracranial haemorrhage is possible.

ICD-10 P531 drug

Also known as: Haemorrhagic disease of the newborn (HDN), VKDB, Vitamin K deficiency

Drugs used for this condition

APhytomenadioneFirst line · Vitamin K1, haemostatic, antidote for coumarin anticoagulant overdosePhytomenadione (Konakion) is first-line prevention and treatment of haemorrhagic disease of the newborn (HDN). AAP 2022 and AEPED recommend a single IM dose of 1 mg (0.5 mg if <1500 g) within the first hour of life in all term newborns. Without prophylaxis the risk of early HDN is about 0.25–1.7 per 1000 births and late HDN (age 2–12 weeks) 4–10 per 100 000, with high mortality from intracranial haemorrhage. Oral regimens (2 mg at birth + 2 mg at day 4–6 + 2 mg at week 4–6) are only acceptable on categorical refusal of injection with informed parental consent. In adults with deficiency from malabsorption, prolonged antibiotic therapy or hepatic failure, 10–20 mg orally or 5–10 mg IM.

How to read tiers A–F

Evidence tiers belong to the drug-indication pair, not to the drug as a whole: the same substance can be A for one condition and F for another.

AStrong evidence – first or second line in international guidelines
BRecommended in selected cases
CStudy data contradict each other
DBenefit not proven, no documented harm
FDocumented harm, or risk without benefit