TABLE 3:

Suggested clinical and laboratory approach to the differential diagnosis of bleeding in newborn babies

Health status	Laboratory investigations			Possible diagnosis
	Platelets	INR (PT)	APTT
Sick	↓	↑	↑	Disseminated intravascular coagulation (usually low factor VIII)
	↓	N	N	Platelet consumption (infection, necrotizing enterocolitis, renal vein thrombosis)
	N	↑	↑	Liver disease, heparinization (usually normal factor VIII)
	N	N	N	Altered vascular integrity (eg, extreme prematurity, severe hypoxia and acidosis
Healthy	↓	N	N	Immune thrombocytopenia, occult infection or thrombosis, abnormal bone marrow function
	N	↑	↑	Hemorrhagic disease of the newborn (vitamin K deficiency)
	N	N	↑	Hemophilia
	N	N	N	Bleeding due to trauma or anatomic abnormalities, qualitative platelet abnormalities

↑ Increased; ↓ Decrease; APTT Activated partial thromboplastin time; DIC Disseminated, intravascular coagulation; INR International normalized ratio; N Normal