Umbilical vasculitis in neonates

The article was professionally consulted by Specialist Doctor I Bui Thi Ha - Pediatrician - Neonatologist - Department of Pediatrics - Neonatology - Vinmec Ha Long International General Hospital.

Taking care of a newborn baby's umbilical cord is an important job and should be paid special attention by parents, because the navel is an extremely sensitive organ. In addition to umbilical cord infection, parents also need to pay attention to the inflammation of the umbilical blood vessels in the child to have a direction to manage and take the child to medical centers for examination and treatment, to avoid dangerous complications from occurring. .

In neonates, the umbilical cord blood vessels consist of 2 arteries and 1 vein. After the baby is born, the umbilical blood vessels will collapse and fibrosis, this process usually lasts from 6-8 weeks after birth, in some cases up to 9-11 weeks. During this time, if the newborn is not cared for properly, bacteria can enter the blood vessels, causing inflammation. After cutting the umbilical cord, blood remains in this area, creating favorable conditions for bacteria to grow.
Neonatal umbilical vasculitis may be primary or secondary to umbilical cord infection. After shedding the umbilical cord at the base of the umbilicus, it is not dry, but it still oozes yellow, pus, and bad smell. There are 2 types of umbilical vasculitis, including:
Umbilical vein inflammation: the umbilical vein in the embryonic stage will atrophy into the round ligament under the liver, however, if the child has umbilical vein inflammation, the collateral circulation will be found on the umbilical cord. According to abdominal distention, hepatosplenomegaly, it is easy to lead to blood infection, peritonitis, liver abscess Umbilical artery inflammation: characterized by red abdomen below the navel, purulent discharge from the pubic bone up to the navel. In clinical practice, children can combine these two symptoms because umbilical vasculitis is common to both arteries and veins. In this case, it is necessary to monitor for bacteremia and peritoneal infection in the child.

Umbilical vasculitis is very dangerous, especially umbilical vein inflammation because the bacteria easily spread to surrounding organs such as liver and bile, leading to sepsis. Therefore, children need to be detected early and taken to medical facilities for active treatment. Treatment methods include:
Removal of necrotic tissue, wide incision in every nook and cranny. Wash the umbilical cord daily with hydrogen peroxide, apply 1% iodine alcohol, leave it open. Strong systemic antibiotic therapy, combined with sepsis such as: Oxacillin, 2nd generation Cephalosporin (cefaclor, cefuroxime) Besides, to prevent umbilical vasculitis in neonates, it is necessary to take the following measures:
Ensure sterility before and after birth Cut and tie the umbilical cord with sterile tools Wash hands before caring for the baby Leave the umbilical cord open and dry, avoid applying chemicals and foreign objects to help the umbilicus dry and fall off Observe the navel and umbilical cord each day days for early detection of infection.

In the process of taking care and cleaning the umbilical cord for a newborn, parents may make a mistake as follows:
The umbilical cord band is too tight or tight, which can create an environment for bacteria to grow, causing the umbilicus to become red. , pus discharge,... Arbitrarily pulling off the umbilical cord when the child's umbilical cord is close to falling off and only a very small part remains, which can cause serious and dangerous harm to the child. Cleaning, bathing and washing the umbilical cord for children but using the wrong method is also the cause of long-term umbilical cord fall or umbilical infection in children. To keep the umbilical cord clean and cause the umbilical cord blood to fall off according to the old concept, the umbilical cord infection of the child is aggravated, making it difficult to treat and leaving sequelae such as sepsis, purulent meningitis, jaundice, ..

In addition to surgical removal and medical treatment, proper umbilical cord care for children with umbilical vasculitis is also important to prevent the infection from progressing, which can lead to dangerous complications. In order to properly care for the baby's umbilical cord, parents should note the following points:
Regarding umbilical cord care: Attention should be paid to keeping the baby's umbilical cord clean and dry. can be exposed to the air. The umbilical cord should absolutely avoid being contaminated with the baby's urine or feces, and at the same time, clean the bottom of the baby's umbilical cord with a cotton pad or gauze soaked in a little antiseptic alcohol 1-2 times a day If the weather is hot, you can wear it. diapers and loose t-shirts to allow ventilation and speed up the drying process. Avoid wearing tight bras until your baby's umbilical cord falls off. In particular, do not attempt to sever the umbilical cord, even if the cord appears loose and less attached. Pay attention to avoid the navel when bathing the baby, the bather should wash their hands with soap to prevent bacteria from entering the child's body. Because if not hygienic, the cut part of the umbilical cord is very susceptible to infection that can lead to tetanus - a serious complication that can easily lead to death in newborns. Mother should bathe the child in turn from head to toe, do not put the child in the basin. In addition, you can use a damp cloth to clean the baby's body, avoiding the umbilical cord. Mother should learn and properly manipulate the umbilical cord bandage for the child, after bathing, the umbilical cord should be changed immediately, need to disinfect hands with 70 degrees of alcohol before use. Remove the baby's old umbilical cord gauze. Then use a cotton pad soaked in Povidine to clean from the tip of the navel to the base of the navel, then apply a new gauze bandage and fix it with a gauze bandage. All manipulations should be done gently, do not bandage the umbilical cord too tightly and clean the umbilical cord should be done daily until the umbilical cord is dry and falls off. If the umbilical cord does not fall off according to the expected time, it should not be rushed because the characteristics of each baby are very different. Never check or pull the umbilical cord with your hands. Always observe and monitor the signs around the baby's navel, take the child to the hospital as soon as the umbilical area is swollen, oozing yellow pus, bleeding or the child has a fever, does not suckle for timely treatment.

The umbilicus is a sensitive organ of the newborn, if not properly cared for, the child is at risk of umbilical cord infection, umbilical vasculitis is very dangerous. Therefore, mothers need to equip themselves with good knowledge of newborn care and promptly take them to medical centers if there are abnormal signs.
With many years of experience in examining and treating diseases in children, now the Pediatrics Department at Vinmec International General Hospital has become one of the major health care centers, capable of examining , screening and treatment of many specialized diseases in children. Therefore, if the child has abnormal signs in the navel, parents can take the child to Vinmec International General Hospital for examination and receive support and advice from doctors.