title: Neonatal Hemophilia: A Rare Presentation.
abstract: Hemophilia A is a X-linked hereditary condition that lead to decreased factor VIII activity, occurs mainly in males. Decreased factor VIII activity leads to increased risk of bleeding events. During neonatal period, diagnosis is made after post-partum bleeding complication or unexpected bleeding after medical procedures. Subgaleal hemorrhage during neonatal period is a rare, severe extracranial bleeding with high mortality and usually related to traumatic labor or coagulation disorders. Subgaleal hemorrhage complications result from massive bleeding. We present a neonate with unremarkable family history and uneventful pregnancy with a vaginal delivery with no instrumentation, presenting with severe subgaleal bleeding at 52 hours of life. Aggressive support measures were implemented and bleeding managed. The unexpected bleeding lead to a coagulation study and the diagnosis of severe hemophilia A. There were no known sequelae. This case shows a rare hemophilia presentation reflecting the importance of coagulation studies when faced with unexplained severe bleeding.
authors.affiliation: Neonatal Intensive Care Unit , Portugal.
authors.forename: Nuno
authors.initials: N
authors.lastname: Ferreira
authors.affiliation: Neonatal Intensive Care Unit , Portugal.
authors.forename: Elisa
authors.initials: E
authors.lastname: Proença
authors.affiliation: Neonatal Intensive Care Unit , Portugal.
authors.forename: Cristina
authors.initials: C
authors.lastname: Godinho
authors.affiliation: Neonatal Intensive Care Unit , Portugal.
authors.forename: Dulce
authors.initials: D
authors.lastname: Oliveira
authors.affiliation: Neonatal Intensive Care Unit , Portugal.
authors.forename: Ana
authors.initials: A
authors.lastname: Guedes
authors.affiliation: Clinical Hematology Department, Centro Hospitalar do Porto , Portugal.
authors.forename: Sara
authors.initials: S
authors.lastname: Morais
authors.affiliation: Neonatal Intensive Care Unit , Portugal.
authors.forename: Carmen
authors.initials: C
authors.lastname: Carvalho
keywords: Hemophilia A; extracranial bleeding; neonate; subgaleal hemorrhage