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Causes and Management

Morris Kletzel, MD; Connie H. Miller, PhD; David L. Becton, MD; William M. Chadduck, MD; Joseph M. Elser, MD

Am J Dis Child. 1989;143(9):1107-1110.

Abstract
• During a 12-month period, four of the five infants with hemophilia known to have been born in Arkansas were examined for head bleeding. Three of the infants had had traumatic delivery, with use of low forceps in two and vacuum extraction in one. In the fourth patient, hemophilia was prenatally diagnosed, and vaginal delivery resulted in cephalohematoma. Diagnosis was delayed in three patients, including one with a family history of hemophilia. Central nervous system bleeding may be more common in hemophilic neonates than has been presumed. Pregnancy management should include consideration of family history of bleeding disorders and carrier testing in appropriate cases. In confirmed carriers, prenatal diagnosis is justified to allow choice of the least traumatic delivery method. Any term neonate with intracranial hemorrhage should be treated as being possibly hemophilic until proved otherwise.

(AJDC. 1989;143:1107-1110)

Author Affiliations
From the Departments of Pediatrics (Drs Kletzel, Miller, Becton, and Elser) and Neurosurgery (Dr Chadduck), University of Arkansas for Medical Sciences and Arkansas Children's Hospital, Little Rock.

Footnotes
Accepted for publication April 20, 1989.

Reprint requests to Department of Pediatrics, Slot 512, University of Arkansas for Medical Sciences, 4301 W Markham, Little Rock, AR 72205 (Dr Kletzel).

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