臨床病理学ジャーナル

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Intra and Post Circumcision Bleeding in Nigerian Neonates: Correlation with Hemostatic Parameters

Eyitayo Emmanuel Fakunle, Kapoona Iwara-Ibiang Eteng, Wuraola Adebola Shokunbi and Clyde Wilson

Circumcision is one of the oldest operations known. In Nigeria there is dearth of knowledge about the incidence of post-circumcision bleeding. Only one out of every seven males in the world is circumcised, however circumcision is the rule rather than the exception within all Nigerian ethnic groups and religions. This study investigated the relationship between some hemostatic parameters, family history and bleeding associated with circumcision of male infants in Ibadan, South West Nigeria. Materials and methods: The study design involved a population of 244 male infants drawn from University College Hospital and Oluyoro Catholic Hospital, in Ibadan, Nigeria. Pre-circumcision PT and aPTT, factor VIIIc level, Platelet Count, incidence of Intra and post-operative bleeding were determined. Results: None of the infants had a family history of bleeding disorder or thrombocytopenia. Six of the full term neonates (2.5%) had prolonged PT while only 2 of the subjects (0.8%) had prolonged aPTT. The factor VIIIc level was between 31-49% in 16.1%, while 1.6% of the neonates had levels between 20-26%. Intra-operatively, 28.9% (manual method, Gomco Clamp) and 4.9% (plastibell) had moderately severe bleeding while excessive postcircumcision bleeding was found in 2.8% and 6.8% for manual methods and plastibell respectively. Conclusion: There was a positive correlation between pre-circumcision aPTT and the degree of post circumcision bleeding. A relationship would have been expected to exist between post-circumcision bleeding and factor VIIIc but this was not found to be significant in this study. Activated Partial Thromboplastin Time would probably be sufficient as a screening hemostatic test for the detection of neonates that may be at risk of bleeding post-operatively.