scholarly journals Association of ABO and Rh incompatibility with neonatal hyperbilirubinaemia

Author(s):  
Apexa S. Patel ◽  
Deepak A. Desai ◽  
Aneri R. Patel

Background: 60% of term new-born have clinical jaundice, in the first week of life. ABO incompatibility is the most common cause of haemolytic disease of the new-born. So early intervention, at proper time, is mandatory to prevent these sequelae.Methods: This study was done at Dhiraj Hospital in Obstetrics and Gynecology Department. It was prospective observational study. 200 new-born with ABO incompatibility and 20 new-born with Rh incompatibility, causing clinically significant neonatal hyperbilirubinemia, were recruited for the clinical study noted.Results: The incidence of ABO incompatibility in our study was 13.79% and of Rh incompatibility was 1.37%. In ABO incompatibility group, 90% new born developed clinical jaundice. In treated group, out of 88 new born, 82 were from O-A and O-B incompatibility group. In ABO incompatibility DCT was positive in only 9%, whereas in Rh incompatibility it was 25%. In ABO incompatibility group, majority, 56% did not require treatment, whereas in Rh incompatibility group 65% required treatment. In ABO incompatibility group only 1% required exchange transfusion whereas in Rh incompatibility, it was required in 10%. In ABO incompatibility, all new-born treated well except, 0.5% developed kernicterus. In Rh incompatibility group, 10% new-born developed kernicterusConclusions: In ABO incompatibility, if jaundice develops, it remains in physiological limits. In presence of some aggravating conditions may present as pathological jaundice. It results in significant morbidity but no mortality. So prevention of aggravating factors is very important, in case of ABO incompatibility. 

Author(s):  
Keshawati Goel ◽  
Anshuman Srivastava

Background: Jaundice is defined as visible reflexion of serum hyperbilirubinemia on mucous membranes and skin as yellowish discoloration. The frequency of icterus among neonates is about 1 in 2500-5000 live births. When there is disparity between the production of bilirubin, conversion from unconjugated to conjugated bilirubin and excretion of bilirubin results in jaundice. Unconjugated bilirubin is usually harmless but it can also cross blood-brain barrier causing neurotoxicity or kernicterus.Methods: A hospital based prospective observational study which is carried out in the department of paediatrics of Teerthanker Mahaveer Medical College, Moradabad, Uttar Pradesh from December 2019 to November 2020 on 74 neonates who required admission for hyperbilirubinemia.Results: The most common jaundice occurred in neonates were idiopathic or breastfeeding jaundice as the neonates were breast fed (47.29%). The second most common cause was ABO incompatibility leading to jaundice in 27 (36.48%) neonates. Incidence of neonatal Sepsis, G6PD deficiency, hypothyroidism and cephalhematoma was 22.9%, 4.1%, 2.70% and 4.1% respectively. Polycythemia contributed to 1.35% and the frequency of hyperbilirubinemia in infants of diabetic mother’s or GDM was 10.8%. Rh incompatibility was seen in 13.5%.Conclusions: G6PD deficiency is a significant cause for NNHB and the cases with pathological jaundice if left untreated may lead to severe neurological deficits and lifelong disabilities, hearing impairment, mental retardation, seizures and movement disorders. Hence we recommend G6PD screening in every newborn with significant hyperbilirubinemia to reduce morbidity and mortality.


2020 ◽  
Vol 8 (1) ◽  
pp. 143
Author(s):  
Avinash Patel ◽  
Karan Saradava ◽  
Hasmukh Chauhan

Background: Etiology of hyperbilirubinemia is not only crucial for optimal management of the patient but also it may have implications for subsequent pregnancies. The objective of this study was to study the clinical profile and the underlying aetiological factors leading to neonatal jaundice in this rural setting of Kutch District, Gujarat, India.Methods: This prospective observational study was conducted in the neonatal intensive care unit (NICU) and Post Natal ward Gujarat Adani Institute of Medical Science, Bhuj, Kutch, Gujarat. Total of 150 cases were enrolled for the study. Blood grouping and Rh typing of baby and mother were done. Cord blood bilirubin and haemoglobin, direct coomb's test (DCT) and bilirubin monitoring were done whenever there was a setting for Rh incompatibility.Results: Among 150 neonates studied, majority had birth weight between 2501g and 3000g. Only 21 babies had birth weight <2.5kg (14%) (Table 2). Of the 150 neonates 85 were males and 65 were females.Conclusions: This study concludes that physiological jaundice is the most common cause of neonatal jaundice in our hospital. This is followed by ABO incompatibility, sepsis, Rh incompatibility and idiopathic cases.


2020 ◽  
Vol 7 (10) ◽  
pp. 1973
Author(s):  
Amit Kumar Thakur ◽  
Mohammad Ashfaque Ansari ◽  
Atindra Mishra ◽  
Saroj Kumar Jha

Background: Neonatal jaundice is extremely common as almost every new-born develops an unconjugated serum bilirubin level of more than 1.8 mg/dl during the first seven days of life. ABO incompatibility is associated in about 20% of all pregnancies but manifestations of ABO haemolytic disease of new-born occurs in <10% of these cases. True incidence of ABO incompatibility, particularly in developing countries like Nepal, is not understood sufficiently. Furthermore, the confirmation of severe ABO incompatibility cannot be made accurately using only a single test. Hence, this study was done to know the outcome of jaundice in ABO incompatibility patients.Methods: This was a descriptive cross-sectional study done at Department of Paediatrics, between August 2018 to July 2019. All term neonates born to ‘O’ positive mother, with blood group A or B positive, and fulfilling the selection criteria were included in the study. Sample size was calculated to be 114 with confidence level at 95% and prevalence of ABO haemolytic disease as 11.4% with margin of error 5%.Results: Severe ABO incompatibility as evident by presence of jaundice within 24 hours of life, a positive result on direct coomb’s test and haemolytic picture on peripheral blood smear was observed in 12% of the total enrolled 200 neonates. Modalities of treatment showed significant relation with severe ABO incompatibility indicating increased need for double volume exchange transfusion in neonates with severe ABO incompatibility.Conclusions: Phototherapy was found to be effective in the management of most of the cases of neonatal jaundice in term ABO incompatible neonates but some cases, requiring exchange transfusion can occur, mostly in presence of positive result on direct Coomb’s test.


2020 ◽  
Vol 8 (1) ◽  
pp. 21-23
Author(s):  
Davis Manuel ◽  
Shajahan R A

Background: In the first week of child birth, neonatal jaundice is the most common problem which leads to delayed hospital discharge and re-admissions. Recognising early neonatal hyperbilirubenemia plays a pivotal role in preventing serious complications. The aim of this study was to study the clinical profile and the aetiological factors leading to neonatal jaundice in rural areas.Subject and Method:This study is a prospective observational study  conducted in neonatal intensive care unit (NICU) and post natal ward . This study was conducted during the period of February 2017 to July 2017. Total 400 neonates were admitted in NICU and post natal ward during this period. Out of them, 100 newborns were having jaundice (Serum bilirubin > 10 mg/dl). 100 cases in total were enrolled in the study. Result:In this study,out of 100 neonates, 70% were males and 30% were females. , 92 were born at term (92%) and remaining 10 were preterm babies (10%). Physiological jaundice constituted 45%, followed by ABO incompatibility constituted 25%, followed by sepsis(1%), Rh incompatibility (8%), idioapathy (8%), prematurity (5%), cephalhematoma (4%), breast feeding (2%), haemolytic anemia (2%) were diagnosed as hereditary spherocytosis. Conclusion:Physiological jaundice is the most common cause of neonatal jaundice followed by ABO incompatibility, sepsis, Rh incompatibility and idiopathic cases. Cephalhematoma, breast feeding jaundice and haemolytic anaemia are the less common causes. Hence, it is required to monitor neonates more appropriately and accurately.


2021 ◽  
Vol 41 (1) ◽  
pp. 67-72
Author(s):  
Sunil Kumar Yadav ◽  
Arun Giri ◽  
Bbita Khanal

Introduction: Neonatal hyperbilirubinemia continues to be the commonest cause of nursery and NICU admissions and readmissions in the neonatal period worldwide. Although most cases are physiological, toxic levels of un-conjugated bilirubin can lead to acute and chronic bilirubin encephalopathy. Hence, this study aimed to study the risk factors for exchange range hyperbilirubinemia in neonates. Methods: This was a hospital-based prospective observational study conducted in a teaching and referral NICU over a period of one year from July 2019 to August 2020. All neonates with diagnosis of hyperbilirubinemia requiring double volume exchange transfusion were included in the study. Risk factors for significant hyperbilirubinemia were analysed with descriptive statistics. P-value of < 0.05 was considered significant wherever applicable. Results: The mean gestational age and birth weight were 38.06 ± 2.13wks and 2611.72 ± 389.39 gm respectively. Fifteen percent of the babies (162) developed hyperbilirubinemia and 28 (17.3%) required double volume exchange transfusion. Among neonates requiring exchange transfusion, 17 were females and 11 were males. Among 28 babies who required DVET, 20 (71.4%) were SGA. ABO incompatibility was present in 14 (50.0%) neonates and Rh incompatibility in 13 (46.4%) neonates. ABO along with Rh incompatibility was present in eight (28.6%) neonates. DCT was positive in six neonates with ABO incompatibility and nine neonates in Rh incompatibility. G6PD deficiency was present in four (14.3%) neonates. Conclusions: The most important risk factors identified were small for gestational age, ABO and Rh incompatibility followed by oxytocin use and sibling treated for jaundice.


1954 ◽  
Vol 29 (4) ◽  
pp. 177-180 ◽  
Author(s):  
Sheamus Dundon
Keyword(s):  

1977 ◽  
Author(s):  
A.J. Silvergleid ◽  
R. Bernstein ◽  
D.S. Burton ◽  
J.B. Tanner ◽  
J.F. Silverman ◽  
...  

A prospective, double-blind clinical study was performed to evaluate the combination of dipyridamole(Persantin)225 mg/day and acetyl salicyclic acid (ASA) 1 g/day prophylaxis of post-operative venous thromboembolism in elective total hip replacement. Patients were stratified according to age, and randomly assigned to receive drug or placebo. All patients were followed with 125I-labelledfibrinogen scanning for one week post-operatively, or until fully mobile. Venography was performed in 67/129 patients; in 27 patients the venogram was obtained to confirm a positive fibrinogen scan, in 40 patients an elective venogram was obtained on the 7th post-operative day to evaluate the operated thigh (a blind area for scanning). Thrombosis (by scan or venogram) was found in 16/66(24%) in the control group, and in 21/63(33%) in the treated group. Overall incidence was 37/129 (29%). Correlation of scan with venography was 90%. There were no clinically significant pulmonary emboli in either group. We conclude that the combination of ASA and dipridamole as given in this study is not effective prophylaxis in elective total hip replacement.


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