title: Evaluation of coagulation tests before newborn circumcision: is it necessary?
abstract: Evaluation of coagulation parameters prior to newborn circumcision is routinely performed in many countries. However, the value of this screening in predicting the bleeding risk is unknown. The aim of this study was to evaluate the correlation between the preoperative prolonged prothrombin time (PT), activated partial thromboplastin time (aPTT) and excessive bleeding after the circumcision in term, healthy newborns without family history of coagulopathy. The medical records of healthy, full term newborns born at VKV American Hospital, in Istanbul, Turkey, between 2009 and 2012 who were circumcised within the first week of life, were reviewed retrospectively. The data for family history of coagulopathy, clinical sign(s) of bleeding during and/or after delivery, preoperative PT, aPTT levels and the amount of bleeding after circumcision were gathered. The most recent medical records of the patients' were also reviewed for any possible, lately diagnosed bleeding disorder. A total of 450 newborns met the above criteria. None had a family history of bleeding disorder or clinical bleeding. A total of 158 (35%) newborns had an aPTT result greater than 54.5 s, 269 (59%) had PT result greater than 15.9 s and 72 (16%) had international normalized ratio result greater than 1.62. Neither of the patients with prolonged PT and/or aPTT had prolonged or excessive bleeding. The evaluation of PT and aPTT before elective newborn circumcision is not necessary in the absence of clinical bleeding or a family history of bleeding disorder. It is rather a habit in general practice and possibly a result of defensive medicine.
authors.affiliation: aDepartment of Pediatric Surgery bDepartment of Pediatrics, Koc University School of Medicine/VKV American Hospital cDepartment of Pediatrics, VKV American Hospital dKoc University School of Nursing, Istanbul, Turkey.
authors.forename: Egemen
authors.initials: E
authors.lastname: Eroğlu
authors.forename: Banu Oflaz
authors.initials: BO
authors.lastname: Sözmen
authors.forename: Sinan Mahir
authors.initials: SM
authors.lastname: Kayiran
authors.forename: Selvinaz
authors.initials: S
authors.lastname: Balci
authors.forename: Berkan
authors.initials: B
authors.lastname: Gürakan
mesh_terms: D002944:Circumcision, Male; D017558:Elective Surgical Procedures; D006470:Hemorrhage / Q000517:prevention & control; D006801:Humans; D007231:Infant, Newborn; D019934:International Normalized Ratio; D008297:Male; D008499:Medical Records; D010314:Partial Thromboplastin Time; D011300:Preoperative Care; D011517:Prothrombin Time; D012189:Retrospective Studies; D014421:Turkey