Bleeding from umbilicus in a neonate: exploring aetiologies of a common presentation

Bleeding from the umbilical stump is a common clinical presentation with varying aetiologies. A mild amount of bleeding often occurs at the time of cord separation. It is often benign; however, sometimes it may be due to an underlying congenital coagulation disorder, especially when in large amounts. Afibrinogenaemia is an uncommon bleeding disorder characterised by the complete absence or severe deficiency of fibrinogen, a vital protein crucial for the regulation of blood clotting. Its estimated prevalence is around 1 in 1 million newborns and is inherited in an autosomal recessive manner. We report a neonate who was diagnosed with congenital afibrinogenaemia and presented with significant bleeding from the umbilicus. The baby is well managed with fibrinogen replacement therapy. Timely identification and intervention proved pivotal in averting potentially life-threatening bleeding incidents in this neonate.