Recent reports have indicated that administration of large doses of a water-soluble vitamin-K analogue (Synkavit) causes an increase in the bilirubin in the serum and was potentially dangerous as regards the development of kernicterus in premature infants. The present report compares the effects of large and small doses of the water-soluble vitamin-K analogue (Synkavit) on the bilirubin in the plasma of premature babies on the fifth day of life. One group of premature babies received 10 mg of Synkavit daily by intramuscular injection for 3 days. Another group received an injection of 1 mg of Synkavit on the first day of life. The bilirubin attained a concentration of 18 mg/100 ml or higher in the plasma in 21 out of 55 babies in the first group receiving the larger dose, while only 2 premature infants out of 51 who received the smaller dose developed a concentration of bilirubin in the plasma of 18 mg/100 ml or higher. There were two deaths from kernicterus in the group receiving the larger dose and no deaths or signs of kernicterus in the group receiving the smaller dose. It is pointed out that a single dose of 0.5 to 1.0 mg of vitamin-K is as effective as larger doses in preventing postnatal hypoprothrombinemia. It is suggested that the routine use of the smaller dose should be adopted in an effort to reduce the incidence of kernicterus in premature infants.

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