STUDIES ON ERYTHROBLASTOSIS DUE TO ABO INCOMPATIBILITY

Detailed clinical and laboratory data have been presented on 21 infants with erythroblastosis due to ABO incompatibility. A careful survey in one newborn service over a six-month period showed that there were 11 cases of erythroblastosis due to ABO incompatibility as compared to 7 cases of erythroblastosis due to Rh incompatibility, suggesting that the disease occurs with greater frequency than has been hitherto reported. No one test is available which can in every case be absolutely diagnostic of the disease. The criteria useful in suggesting the diagnosis are listed. Practically, the presence of a major blood group incompatibility between infant and mother with a negative Coombs' test, clinical jaundice in the first 24 hours, and a serum bilirubin level of more than 10 mg./100 cc. at 24 hours or less is sufficient to make the diagnosis in the absence of manifest infection. The same criteria for treatment as applied to Rh erythroblastosis should be applied to erythroblastosis due to ABO incompatibility in the light of our present knowledge.

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Risk of neonatal hyperbilirubinemia in babies born to ‘O’ positive mothers: A prospective cohort study

Kathmandu University Medical Journal ◽

10.3126/kumj.v7i1.1758 ◽

1970 ◽

Vol 7 (1) ◽

pp. 11-15 ◽

Cited By ~ 4

Author(s):

BK Kalakheti ◽

R Singh ◽

NK Bhatta ◽

A Karki ◽

N Baral

Keyword(s):

Cohort Study ◽

Blood Group ◽

Prospective Cohort Study ◽

Bilirubin Level ◽

Prospective Cohort ◽

Serum Bilirubin ◽

Serum Bilirubin Level ◽

Health Science ◽

Abo Incompatibility ◽

Laboratory Services

Introduction: Hyperbilirubinemia in a neonate is one of the most common problems that may occur in 60-70 % of term and 80% of preterm babies. It is known to be associated with significant morbidity like neonatal bilirubin encephalopathy and even death. Clinically, and almost exclusively ABO incompatibility occur in ‘A' and ‘B' blood group babies of O ‘+ve' mothers. These babies are reported to be at high risk of severe hyperbilirubinemia (serum bilirubin level more than 16 mg/dl). Objectives: To find out the incidence of hyperbilirubinemia in babies born to ‘O' positive mothers. To estimate the risk of ABO incompatibility in babies born to ‘O' positive mothers. Materials and methods: A prospective cohort study conducted in B. P. Koirala institute of Health Science (Department of Pediatrics and Dept. of Gynae and Obstetric) from July 2002 to June 2003. A total of 199 women having ‘O' positive blood group admitted to the Department of Gynae and Obstetric were included in the study. A piloted proforma was used to collect information. The blood group of neonates was tested by tile and slide method and serum bilirubin was estimated by diazo method in the Central Laboratory Services and Emergency laboratory of BPKIHS. The data was observed and analysis was carried out using statistical software SPSS-10. Results: Total 37 (18.5%) babies had developed hyperbilirubinemia and among them 14 (38%) were from group of babies having ‘O' Positive blood group and 23 (62%) were from group of babies having other than ‘O' Positive blood group. There was 2.6 times higher chance of having hyperbilirubinemia in the babies with ABO incompatibility than ‘O' Positive babies after adjusting other significant variables. Conclusion: Among different significantly associated variables, ABO incompatibility was found to be a major risk factor for neonatal hyperbilirubinemia.It was seen that neonate with ABO incompatibility had two times higher chances of having hyperbilirubinemia than those babies with O ‘+ve' blood group. This finding in BPKIHS suggests that there is a need of screening cord blood bilirubin and continuous monitoring of bilirubin level in the hospital especially among ABO incompatible neonates. Key words: Hyperbilirubinemia, Neonatal Jaundice, ABO-incompatibility doi: 10.3126/kumj.v7i1.1758 Kathmandu University Medical Journal (2009), Vol. 7, No. 1, Issue 25, 11-15

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Is Cord Blood Bilirubin Level a Reliable Predictor for Developing Significant Hyperbilirubinemia?

American Journal of Perinatology ◽

10.1055/s-0038-1667368 ◽

2018 ◽

Vol 36 (03) ◽

pp. 317-321

Author(s):

Caner Dogan ◽

Zeynep Okmen ◽

Seda Gulec ◽

Selma Aktas

Keyword(s):

Cord Blood ◽

Blood Group ◽

Bilirubin Level ◽

Serum Bilirubin ◽

Mode Of Delivery ◽

Blood Groups ◽

Serum Bilirubin Level ◽

Delay In Diagnosis ◽

Rh Incompatibility ◽

The Mean

Objective We aimed to investigate whether cord blood bilirubin (CBB) level could be used to identify the newborns at a high risk of developing hyperbilirubinemia. Study Design Total and direct serum bilirubin level were evaluated from umbilical cord blood of newborns. We checked blood groups and Rh status of all mothers and determined blood groups and direct Coombs test (DC) of newborns born to mothers whose blood group was O type or Rh negative to determine the maternal–fetal blood group or Rh incompatibility. Results A total of 418 newborns were included, and phototherapy (PT) was required in 17 newborns. The cutoff value of CBB for predicting the occurrence of significant hyperbilirubinemia requiring PT was 1.67 mg/dL, with a sensitivity of 82% and specificity of 99%. The mean CBB level in babies receiving PT was 2.4 ± 0.9 mg/dL. When blood group, CBB level, DC, gender, and mode of delivery were assigned as possible risk factors, multıvariate analysis showed ABO, Rh incompatibility, and CBB level increased the risk of PT requirement. Conclusion CBB could be useful to determine newborns at a risk of developing hyperbilirubinemia and prevent developing severe complications due to delay in diagnosis.

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Cord Serum Bilirubin Level in Predicting the Development of Significant Hyperbilirubinemia in Newborns with ABO Incompatibility

Journal of Nepal Paediatric Society ◽

10.3126/jnps.v35i3.13797 ◽

2016 ◽

Vol 35 (3) ◽

pp. 231-236

Author(s):

Sunita Arora ◽

Shifali

Keyword(s):

Blood Group ◽

Bilirubin Level ◽

Serum Bilirubin ◽

Tertiary Care ◽

Serum Bilirubin Level ◽

Total Serum ◽

Care Hospital ◽

Hemolytic Disease ◽

Cord Serum ◽

Abo Incompatibility

Introduction: Neonatal hyperbilirubinaemia is common problem which is benign in majority of neonates. Rh iso immune hemolytic disease as a cause of hyperbilirubinemia is becoming nearly nonexistent due to the use of prophylactic anti D. Hence Isoimmune hemolytic disease due to ABO incompatibility assumes significance as a cause of significant hyperbilirubinaemia. This study was conducted to determine the incidence of ABO incompatibility, ABO iso immune disease in new born, to determine critical cord serum bilirubin level to predict subsequent significant hyperbilirubinemia.Material and Methods: The study was done in neonatal ICU of a tertiary care hospital where 100 full term healthy newborns with B.W≥2500gm and gestational age ≥37 wk with blood group A, B, AB, born to mothers with O blood group without simultaneous Rh incompatibility at SGRDIMSR were included. Serum bilirubin was measured approximately at 12-24hrs, 36-48hrs, 60-72hrs. Results: Out 100 ABO incompatible newborns 33(33%) developed ABO isoimmune disease manifesting as significant hyperbilirubinaemia with any of the four total serum bilirubin levels exceeding threshold levels defined for phototherapy. TSB of ≥ 2.16mg/d1 from cord blood has a sensitivity of 100% specificity of 89.55%, NPV 100% and PPV of 82.50% to predict significant hyperbilirubinaemia. Conclusion: A critical cord S.bilirubin between 2.16 mg/d1 and 4.09mg/d1 will predict all newborns who will have significant hyperbilirubinaemia and can be used as a safe demarcator to decide time of discharge. Any therapeutic intervention if necessary can be started as early as possible.J Nepal Paediatr Soc 2015; 35(3): 231-236

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Learning from claims: hyperbilirubinaemia and kernicterus

Archives of Disease in Childhood - Fetal and Neonatal Edition ◽

10.1136/archdischild-2017-314622 ◽

2018 ◽

Vol 104 (2) ◽

pp. F202-F204 ◽

Cited By ~ 4

Author(s):

Janet M Rennie ◽

Jeanette Beer ◽

Michele Upton

Keyword(s):

Cerebral Palsy ◽

Bilirubin Level ◽

Neonatal Jaundice ◽

Serum Bilirubin ◽

Serum Bilirubin Level ◽

Sufficient Information ◽

Haemolytic Disease ◽

Total Cost ◽

Abo Incompatibility ◽

Extremely Preterm

We examined claims made against the National Health Service (NHS) involving neonatal jaundice in order to determine whether there were lessons that could be learnt from common themes.This was a retrospective anonymised study using information from the NHS Resolution database for 2001–2011.Twenty cases (16 males) had sufficient information for analysis. Fifteen had confirmed cerebral palsy and two young children had damage to the globus pallidus without confirmed CP. In three cases, the outcome was uncertain. Two were extremely preterm, five were born at 34–36 weeks’ gestation. Jaundice was typically present very early in life; in four cases, it was noted at less than 24hours of age, and in 14 cases, it was first noted on the second to third day. There was a lag between recognition and readmission, with a range of 26–102 hours. The peak serum bilirubin level was over 600 µmol/L in all the babies born at term. An underlying diagnosis was found in all but two; six had glucose-6-phosphatase deficiency (one also had Gilbert’s syndrome); five were diagnosed with ABO incompatibility; three with Rh haemolytic disease; one with spherocytosis and three preterm. The total cost of these claims by August 2017 was almost £150.5 million. This figure is likely to rise.These data show that, in the group who litigate, babies who develop kernicterus generally have an underlying diagnosis. We recommend adherence to theNational Institute for Health and Care Excellence guideline that recommends measuring the bilirubin level within 6 hours in all babies who are visibly jaundiced.

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Hyperbilirubinemia in Preterm Infants Admitted to Neonatal Intensive Care Units in Ethiopia

Global Pediatric Health ◽

10.1177/2333794x20985809 ◽

2020 ◽

Vol 7 ◽

pp. 2333794X2098580

Author(s):

Sara Aynalem ◽

Mahlet Abayneh ◽

Gesit Metaferia ◽

Abayneh G. Demissie ◽

Netsanet Workneh Gidi ◽

...

Keyword(s):

Intensive Care ◽

Intensive Care Units ◽

Preterm Infants ◽

Bilirubin Level ◽

Serum Bilirubin ◽

Serum Bilirubin Level ◽

Total Serum ◽

P Value ◽

Abo Incompatibility ◽

Preterm Babies

Background. Hyperbilirubinemia is prevalent and protracted in preterm infants. This study assessed the pattern of hyperbilirubinemia in preterm infants in Ethiopia. Methods. This study was part of multi-centered prospective, cross-sectional, observational study that determined causes of death among preterm infants. Jaundice was first identified based on clinical visual assessment. Venous blood was then sent for total and direct serum bilirubin level measurements. For this study, a total serum bilirubin level ≥5 mg/dL was taken as the cutoff point to diagnose hyperbilirubinemia. Based on the bilirubin level and clinical findings, the final diagnoses of hyperbilirubinemia and associated complications were made by the physician. Result. A total of 4919 preterm infants were enrolled into the overall study, and 3852 were admitted to one of the study’s newborn intensive care units. Of these, 1779 (46.2%) infants were diagnosed with hyperbilirubinemia. Ten of these (0.6%) developed acute bilirubin encephalopathy. The prevalence of hyperbilirubinemia was 66.7% among the infants who were less than 28 weeks of gestation who survived. Rh incompatibility ( P = .002), ABO incompatibility ( P = .0001), and sepsis ( P = .0001) were significantly associated with hyperbilirubinemia. Perinatal asphyxia ( P-value = 0.0001) was negatively associated with hyperbilirubinemia. Conclusion. The prevalence of hyperbilirubinemia in preterm babies admitted to neonatal care units in Ethiopia was high. The major risk factors associated with hyperbilirubinemia in preterm babies in this study were found to be ABO incompatibility, sepsis, and Rh isoimmunization.

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Hospital Readmission Due to Neonatal Hyperbilirubinemia

PEDIATRICS ◽

10.1542/peds.96.4.727 ◽

1995 ◽

Vol 96 (4) ◽

pp. 727-729 ◽

Cited By ~ 5

Author(s):

Daniel S. Seidman ◽

David K. Stevenson ◽

Zivanit Ergaz ◽

Rena Gale

Keyword(s):

Bilirubin Level ◽

Serum Bilirubin ◽

Early Discharge ◽

Serum Bilirubin Level ◽

Neonatal Hyperbilirubinemia ◽

Term Infants ◽

Abo Incompatibility ◽

Apparent Reason ◽

Breast Fed

Severe neonatal hyperbilirubinemia can occur without apparent reason in term healthy breast-fed infants and some develop kernicterus. The aim of our study was to assess the incidence of severe hyperbilirubinemia in term healthy newborns discharged from the hospital. From January 1 through December 31, 1994, 6705 infants were delivered at Bikur-Cholim and Misgav-Ladach Community Hospitals. All 1448 newborns discharged with a serum bilirubin level >10.0 mg/dL were instructed to return to the hospital within 3 days for follow-up, as well as bilirubin determination. Twenty-one newborns with a bilirubin level >18.0 mg/dL were identified and readmitted at mean ± standard deviation (SD) 5.5 ± 1.8 (range, 5 to 10 days of life). This represents 1.7% of the 1220 infants who returned for follow-up examination. Mean ± SD serum bilirubin levels at readmission were 19.6 ± 2.5 mg/dL. All but one of the infants were breast-fed. No cases of ABO incompatibility were found and two newborns were glucose-6-phosphate dehydrogenase (G6PD)-deficient. Sepsis work-up and direct Coomb's tests were negative in all cases. None had hemolysis or were found to have any cause for hyperbilirubinemia other than breast-feeding. Phototherapy was provided in all but two cases, and an exchange transfusion was performed in one case. Three additional infants, with bilirubin levels <10 mg/dL at discharge, were readmitted due to hyperbilirubinemia. One was diagnosed with neonatal hepatitis. We conclude that, based on our study population, 0.36% of term infants may subsequently develop severe neonatal hyperbilirubinemia in the first postnatal week. Adequate follow-up programs should be available when early discharge of healthy term newborns is considered.

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Analytical study of the reality of cliques ABO incompatibility in newborns at AlYarmouk and Al-Kadhimiya teaching hospitals in Baghdad province

The Iraqi Journal of Veterinary Medicine ◽

10.30539/iraqijvm.v37i1.330 ◽

2013 ◽

Vol 37 (1) ◽

pp. 47-51

Author(s):

Mustafa A.K. Al-Taie

Keyword(s):

Blood Group ◽

Bilirubin Level ◽

Analytical Study ◽

Serum Bilirubin Level ◽

Teaching Hospitals ◽

Female Ratio ◽

Abo Incompatibility ◽

Group A ◽

Group B ◽

Male To Female

In this study blood samples were collected from 150 newborns (NBs), In a period from 20082010, with blood groups A and B from mother’s blood group O positive and those who do not have any other reason for the jaundice..Of 150 NBs, 105 have blood group A and 45 with group B. And the male to female ratio was 1.7:1. The average of NBs age at the onset of jaundice was 19.02 hrs, it was earlier in blood group B and in newborns of first pregnancy. The average of serum bilirubin level at 24 hours was 5.70 mg/dl; there was no statistical value of the blood group and the sex of the NBs in the bilirubin level. Newborns had anemia at delivery in 12 cases, 6 of them were premature. Fifty one NBs were followed for late anemia and found 36 (70%) had anemia. Comparing results between NBs who had anemia and those who had not, found that the bilirubin level was higher in anemic NBs, and they had longer stay in Hospital

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