Кровоизлияние в кожу у новорожденного Проект клинических рекомендаций для обсуждения специалистами неонатологами и педиатрами: ПЕРЕДОВАЯ СТАТЬЯ

Дмитрий Олегович  Иванов; Галина Николаевна  Чумакова; Александра Сергеевна  Панченко; Екатерина Николаевна  Балашова; Елена Венедиктовна  Бем; Марина Ивановна  Леваднева; Ирина Владимировна  Мызникова; Светлана Евгеньевна  Павлова; Лариса Андреевна  Романова; Лариса Арзумановна  Федорова; Тамара Владимировна  Белоусова; Ирина Владимировна  Солодкова

doi:10.56871/PED.2025.82.67.001

Hemorrhage in the skin of a newborn Draft clinical recommendations for discussion by neonatologists and pediatricians

EDITORIAL

Dmitry O. Ivanov Saint Petersburg State Pediatric Medical University, Saint Petersburg, Russia
Galina N. Chumakova Saint Petersburg State Pediatric Medical University, Saint Petersburg, Russia
Alexandra S. Panchenko Saint Petersburg State Pediatric Medical University, Saint Petersburg, Russia
Ekaterina N. Balashova National Medical Research Center of Obstetrics, Gynecology and Perinatology named after Academician V.I. Kulakov, Moscow, Russia
Elena V. Bem Saint Petersburg State Pediatric Medical University, Saint Petersburg, Russia
Marina I. Levadneva Saint Petersburg State Pediatric Medical University, Saint Petersburg, Russia
Irina V. Myznikova Saint Petersburg State Pediatric Medical University, Saint Petersburg, Russia
Svetlana E. Pavlova Saint Petersburg State Pediatric Medical University, Saint Petersburg, Russia
Larisa A. Romanova Saint Petersburg State Pediatric Medical University, Saint Petersburg, Russia
Larisa A. Fedorova Saint Petersburg State Pediatric Medical University, Saint Petersburg, Russia
Tamara V. Belousova Novosibirsk State Medical University, Novosibirsk, Russia
Irina V. Solodkova Saint Petersburg State Pediatric Medical University, Saint Petersburg, Russia

Keywords:

кровоизлияние в кожу новорожденные кожный геморрагический синдром новорожденных нарушения системы гемостаза новорожденных петехии skin hemorrhage newborns cutaneous hemorrhagic syndrome of newborns disorders of the hemostasis system of newborns petechiae

Abstract

The hemostasis system of newborns is called “developmental hemostasis” and plays an important role in the adaptation of a newborn child to the conditions of the extrauterine environment. Hemorrhages in newborns occur both when individual parts of the hemostasis system (vessels, platelets, coagulation factors) are damaged, and when they are combined. The incidence of cutaneous hemorrhagic syndrome of newborns ranges from 15.0 to 24.9% in neonatal departments of obstetric institutions. According to the type of hemostatic disorders, cutaneous hemorrhagic syndrome is divided into microcirculatory, hematomic and mixed types. The etiopathogenetic classification identifies platelet disorders (qualitative and quantitative) and blood clotting disorders that may be associated with the formation of hematomas and bruises, a combination of these two factors is possible. Cutaneous hemorrhagic syndrome can occur as an isolated one or be accompanied by other manifestations of hemorrhagic syndrome, such as gastrointestinal bleeding, intracranial hemorrhages, retinal bleeding, adrenal hemorrhages, etc. When examining a child with a skin hemorrhage, it is necessary to conduct a thorough examination, collect a hereditary and perinatal anamnesis, perform a general blood test and coagulogram, neurosonography and ultrasound examination of the abdominal cavity, kidneys and adrenal glands to exclude internal bleeding, conduct an oculist examination to exclude retinal hemorrhages. Local treatment of hemorrhages in the skin is not carried out, if disorders of the hemostasis system are detected, then correction of these disorders is carried out, which led to the development of cutaneous hemorrhagic syndrome.

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