Melena neonatorum

Abstract

A male infant was born at 39 weeks of gestation of a healthy 24-year-old woman with good prenatal care. He was born by eutocic delivery with bloody amniotic fluid noted and suspicion of marginal placental detachment. At his second hour of life, the newborn eliminated grossly bloody meconium. He had no signs of illness, was hemodynamically stable and physical examination was unremarkable. A nasogastric tube was introduced, and gastric aspirate had no signs of bleeding. Blood tests and abdominal ultrasonography showed no alterations. The APT test was performed, and the result was suggestive of swallowed maternal blood. The presence of blood in the gastrointestinal tract or stools of neonates poses important differential diagnoses. It is essential to determine whether blood results from swallowed blood of maternal origin or if it is secondary to disease in the newborn in order to obviate unnecessary exams and interventions if the maternal origin is proven.

Keywords

• newborn
• hemorrhage
• melena
• meconium
• hemoglobin
• amniotic fluid