obsolete gastrointestinal hemorrhage of fetus or newborn

Gastrointestinal Hemorrhage in Fetus or Newborn: Obsolete Causes

While significant advances have been made in understanding and managing gastrointestinal (GI) bleeding in the fetus or newborn, some causes are now considered obsolete. These outdated explanations include:

• Fetal-maternal hemorrhage: Although still a concern, the symptoms of this condition can be subtle and nonspecific [10]. A severe case was reported in a newborn who presented with anemia, but the exact cause remained uncertain.
• Vitamin K deficiency bleeding (VKDB): While VKDB is still a recognized cause of GI bleeding in newborns, it is now considered a specific type of hemorrhagic disorder rather than a distinct entity [15]. The term "hemorrhagic disorder of the newborn" encompasses all types of bleeding disorders, including VKDB.
• Gastric and duodenal ulcers: Although rare, gastric and duodenal ulcers can cause GI bleeding in newborns. A case report described a full-term newborn who presented with acute onset of GI bleeding due to these ulcers [12]. However, the exact etiology remains uncertain.

It's essential to note that while these causes are now considered obsolete, they may still be relevant in specific cases or contexts. Modern medical practice emphasizes a more nuanced understanding of GI bleeding in the fetus and newborn, taking into account various factors such as congenital abnormalities, infectious esophagitis, and hemorrhagic disorders [4, 7, 14].

Based on the provided context, it appears that there are several diagnostic tests used to determine whether a newborn has experienced gastrointestinal (GI) bleeding. Here are some of the diagnostic modalities mentioned:

• Apt-Downey test: This is a medical test used to differentiate fetal or neonatal blood from maternal blood found in a newborn's stool or vomit, or from maternal vaginal blood [2].
• Esophagogastroduodenoscopy (EGD) and colonoscopy: These are endoscopic procedures that can be used to visualize the upper and lower GI tract and identify any bleeding sites [1].
• Abdominal ultrasonography or computed tomography (CT): These imaging modalities can be used to evaluate the abdominal organs and detect any signs of bleeding [1].
• Fecal calprotectin: This is a non-invasive test that can be used to detect inflammation in the GI tract, which may indicate bleeding [13].

It's worth noting that the most common cause of suspected GI bleeding in newborns is maternal blood ingestion during delivery or while an infant is being fed [4]. However, it's also possible for a fetus to experience significant hemorrhage into the maternal circulation, which can compromise fetal health and result in stillbirth or delivery of a severely anemic infant [5].

In terms of obsolete diagnostic tests, the alkali denaturation test (also known as the Apt test) is mentioned as a method that was previously used to differentiate fetal from maternal blood. However, it's not clear whether this test is still widely used today.

References:

[1] Context result 1 [2] Context result 2 [4] Context result 4 [5] Context result 5