Chen S H, Soong W J, Hsieh Y L, Chen S J, Hwang B
Department of Pediatrics, Veterans General Hospital-Taipei, Taiwan, R.O.C.
Zhonghua Yi Xue Za Zhi (Taipei). 1994 Jul;54(1):62-6.
Intracranial hemorrhage (ICH) in a neonate is an uncommon presentation of hemophilia. Its occurrence is invariably preceded by mild-to-moderate head injury, unlike adult hemophiliacs in whom ICH occurs without prior head injury in half the cases. The bleeding event may follow a minor injury of labor (eg, prolonged second stage of labor or the use of forceps). In a recent experience at our hospital, a 6 D/O male baby with hemophilia A presenting with ICH after traumatic delivery was later found to have factor VIII deficiency. We suggest that prenatal management for suspected cases should take family history of bleeding disorders and carrier testing into consideration. Any term neonate with ICH should eliminate the possibility of hemophilia until proved otherwise. Some specific diagnostic and therapeutic recommendations to assist the clinician to evaluate an infant with ICH and prolonged PTT are discussed.
新生儿颅内出血（ICH）是血友病的一种罕见表现。与成年血友病患者不同，成年患者半数病例的颅内出血发生前并无头部损伤，而新生儿颅内出血总是在轻度至中度头部损伤之后发生。出血事件可能继发于分娩时的轻微损伤（例如，第二产程延长或使用产钳）。在我们医院最近的一次经历中，一名患有甲型血友病的6日龄男婴在创伤性分娩后出现颅内出血，后来发现其缺乏凝血因子VIII。我们建议，对于疑似病例的产前管理应考虑出血性疾病家族史和携带者检测。任何患有颅内出血的足月新生儿在排除其他可能性之前都应考虑血友病。本文讨论了一些具体的诊断和治疗建议，以帮助临床医生评估患有颅内出血和部分凝血活酶时间延长的婴儿。
