scholarly journals Efficacy of early IV Immunoglobulin in management of neonatal hyperbilirubinemia due to Rh incompatibility and ABO incompatibility: A hospital based study

2021 ◽  
Vol 09 (04) ◽  
Author(s):  
Dr Ponung lego ◽  
Keyword(s):  
Neonatal Hyperbilirubinemia ◽  
Abo Incompatibility ◽  
Rh Incompatibility ◽  
Iv Immunoglobulin

scholarly journals Evaluation of Neonatal Hemolytic Jaundice: Clinical and Laboratory Parameters

2015 ◽  
Vol 3 (4) ◽  
pp. 694-698 ◽  
Author(s):  
Anet Papazovska Cherepnalkovski ◽  
Vjekoslav Krzelj ◽  
Beti Zafirovska-Ivanovska ◽  
Todor Gruev ◽  
Josko Markic ◽  
...  
Keyword(s):  
Hematological Parameters ◽  
Significant Risk ◽  
Neonatal Hyperbilirubinemia ◽  
Diagnostic Methods ◽  
Mean Values ◽  
Laboratory Parameters ◽  
Abo Incompatibility ◽  
Rh Incompatibility ◽  
Severe Hyperbilirubinemia ◽  
Blood Grouping

BACKGROUND: Neonatal jaundice that occurs in ABO or Rhesus issoimunisation has been recognized as one of the major risk factors for development of severe hyperbilirubinemia and bilirubin neurotoxicity.AIM: Aim of our study was to investigate clinical and laboratory parameters associated with hemolytic jaundice due to Rh and ABO incompatibility and compare results with the group of unspecific jaundice.MATERIAL AND METHODS: One hundred sixty seven (167) neonatal hyperbilirubinemia cases were included in the study, 24.6% of which presented with ABO/Rhesus type hemolytic jaundice, and the rest with unspecific jaundice. Evaluation included: blood count, reticulocites, serum bilirubin, aminotransferases, blood grouping, and Coombs test, also the day of bilirubin peak, duration of the hyperbilirubinemia, and additional bilirubin measurements.RESULTS: We showed significantly lower mean values of hemoglobin, erythrocytes and hematocrit and significantly higher values of reticulocytes in the group of ABO/Rh incompatibility compared to the group of jaundice of unspecific etiology; also an earlier presentation and a higher-grade jaundice in this group.CONCLUSIONS: The laboratory profile in ABO/Rh isoimmunisation cases depicts hemolytic mechanism of jaundice. These cases carry a significant risk for early and severe hyperbilirubinemia and are eligible for neurodevelopmental follow-up. Hematological parameters and blood grouping are simple diagnostic methods that assist the etiological diagnosis of neonatal hyperbilirubinemia.

scholarly journals Effectiveness of conventional phototherapy, intensive phototherapy and exchange transfusion in treating neonatal jaundice at Fatima Al-Zahra Hospital for maternity and children in Baghdad

2020 ◽  
Vol 16 (2) ◽  
pp. 25-29
Author(s):  
Ahmed Salih Marzoog ◽  
Hussein Naeem Mohammed ◽  
Kholod Dhaher Habib
Keyword(s):  
Exchange Transfusion ◽  
Neonatal Jaundice ◽  
Neonatal Care ◽  
Neonatal Hyperbilirubinemia ◽  
Total Serum ◽  
Common Disease ◽  
Female Ratio ◽  
Abo Incompatibility ◽  
Rh Incompatibility ◽  
Neonatal Care Unit

Background: Neonatal hyperbilirubinemia is a common disease in neonates especially in early days of birth that requires a good and successful treatment for reducing the severity and its complications that can produce important and irreversible effects. Objectives: To evaluate the effectiveness of conventional phototherapy, intensive phototherapy and exchange transfusion on outcomes of neonatal jaundice at Fatima Al-Zahra Hospital for maternity and child care in Baghdad. Patients & Methods: A retrospective study was carried out using medical records of neonates with diagnosis of unconjugated jaundice, admitted in the septic neonatal care unit of Fatima Al-Zahra hospital over 6 months period between 1st May till 31st October 2018. The total serum bilirubin, fractionations and blood group were done in all cases. They treated with conventional phototherapy, intensive phototherapy and exchange transfusion according to the severity of jaundice. Results: Total neonates admitted from 1st may to 31st October 2018 in septic neonatal care unit were 1254, among them 432 (35%) were diagnosed as unconjugated neonatal jaundice “indirect hyperbilirubinemia”. Male: Female ratio (1.4:1), males 256(59.3%), females 176(40.7%). Physiological jaundice was the most common cause 129(29.9%) cases. Prematurity in 104(24.1%) and ABO incompatibility 59(13.7%) while Rh incompatibility 14(3.2%), sepsis 8(1.9%) and unknown causes of jaundice were 118(27.3%) because lack of lab facilities. Conventional phototherapy was the most common kind of treatment in 237(55%) while intensive phototherapy used in 175(40.3%) cases with successful reduction in T.S.B level and the rate of improvement without need for exchange transfusion (92%) (161/175).Only 20(4.5%) cases were treated with exchange transfusion especially for ABO incompatibility 8 (42.1%) cases and Rh incompatibility 4 (21.1%) cases. Most of neonates 429 (99.3%) discharged with complete improvement and only 2 (0.5%) neonates suffered from kernicterus and one death (0.2%). Conclusion: Conventional phototherapy is still the standard treatment of mild to moderate indirect hyperbilirubinemia. Use of intensive phototherapy in the treatment of unconjugated neonatal hyperbilirubinemia is effective in reducing T.S.B level, need for exchange transfusion and hospital staying. Recommendations: provide aseptic neonatal care unit in the hospital with further number of intensive phototherapy devices as it is so effective in treating unconjugated neonatal jaundice and reduces need for exchange transfusion as it is proven in the study.

scholarly journals Neonatal Hyperbilirubinemia treatment by Locally Made Low-Cost Phototherapy Units

2021 ◽  
Vol 31 (1) ◽  
Author(s):  
Netsanet Workneh Gidi ◽  
Matthias Siebeck
Keyword(s):  
Bilirubin Level ◽  
Medical Center ◽  
Low Cost ◽  
Retrospective Chart Review ◽  
Maximum Level ◽  
Neonatal Hyperbilirubinemia ◽  
Common Finding ◽  
Abo Incompatibility ◽  
Rh Incompatibility ◽  
Severe Hyperbilirubinemia

BACKGROUND፡ Hyperbilirubinemia is a very common finding in neonates and may occasionally cause severe morbidity and even mortality. Severe hyperbilirubinemia is typically treated, either with phototherapy or exchange transfusions. This study assessed the effectiveness of a locally manufactured phototherapy device for reducing serum bilirubin in neonates with severe hyperbilirubinemia.METHODS: Retrospective chart review was carried out to assess the outcome of 32 infants who were treated for neonatal hyperbilirubinemia at Jimma Medical Center (JMC) from May, 2017 to April, 2018. RESULTS: Out of 75 charts reviewed, only 32 had subsequent bilirubin level determination, 18(56.3%) of them were males. The age at which jaundice was noticed and confirmed with plasma bilirubin level was 4 + 2.7 days (mean+SD). Sepsis was thought to be the cause of hyperbilirubinemia in 13(40.5%) of the cases, while hemolysis from ABO incompatibility or RH incompatibility contributed in 5(15.6%) and 3(9.4) of the infants respectively. The mean (minimum, maximum) level of baseline TSB was 21.4(14, 55) mg/dL. Five infants (15.6%) had exchange transfusions because of extreme hyperbilirubinemia. The duration of phototherapy and decline in TSB were 5.34 +2.8 days and 2.2+1.5mg/dl/day (mean+SD) respectively. The levels of TSB before and at the end of phototherapy were significantly different (p<0.001).CONCLUSION: Acceptable reduction of TSB was achieved by using locally manufactured PT devices. Benefits included better accessibility and lower price and maintenance costs. High mean baseline TSB was observed, and duration of phototherapy is prolonged which could indicate late diagnosis compared to similar studies.

scholarly journals Risk Factors and Causes of Neonatal Hyperbilirubinemia: A Systematic Review Study

2020 ◽  
Vol 8 (4) ◽  
pp. 211-222
Author(s):  
Hassan Boskabadi ◽  
◽  
Forough Rakhshanizadeh ◽  
Ali Moradi ◽  
Maryam Zakerihamidi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Birth Weight ◽  
G6pd Deficiency ◽  
Neonatal Jaundice ◽  
Diabetic Mother ◽  
Neonatal Hyperbilirubinemia ◽  
Abo Incompatibility ◽  
Rh Incompatibility ◽  
Review Study

Context: Jaundice is a common problem and the most common risk factor for hospitalization during the neonatal period.      Objective: The prevention of neonatal hyperbilirubinemia would not be possible without identifying its predisposing risk factors. The present systematic review study aims to determine the risk factors of neonatal jaundice. Data Sources: Databases including Science Direct, Cochrane Library, Web of Science (ISI), PubMed, and Google Scholar were searched to identify all eligible papers concerning the risk factors of neonatal hyperbilirubinemia.  Study Selection: This systematic review was performed to review the causes and risk factors of neonatal hyperbilirubinemia. Finally, 18 articles were defined as eligible for further review. Data Extraction: The keywords included neonates, jaundice, hyperbilirubinemia, and risk factors. The inclusion criteria were studies determining jaundice risk factors, while papers with only published abstracts were excluded. Results: A total of 18 eligible articles (3 retrospective, 4 prospective, 10 cross-sectional, and 1 historical cohort) out of 421 retrieved articles were included in this review. The etiologic causes for neonatal jaundice were ABO incompatibility (24.6%), infection (including UTI and sepsis) (13.7%), G6PD deficiency (9.4%), Rh incompatibility (7%), and cephalohematoma (2.9%), while, known predisposing factors for neonatal jaundice included unknown (33.2%), low birth weight (30.9%), hyperbilirubinemia in siblings (22.7%), prematurity (20.1%), and infant of diabetic mother (6.7%). Conclusion: According to our review with considering the studies, the etiologic causes for neonatal jaundice are ABO incompatibility, infection (including UTI and sepsis), G6PD deficiency, Rh incompatibility, and cephalohematoma. While, known predisposing factors for neonatal jaundice include low birth weight, hyperbilirubinemia in siblings, prematurity, and infant of diabetic mother.

The Development of Immunological Factors in Infants with Hyperbilirubinemia

PEDIATRICS ◽  
1970 ◽  
Vol 45 (1) ◽  
pp. 102-104
Author(s):  
Zdenka Nejedlá
Keyword(s):  
Exchange Transfusion ◽  
Causative Factor ◽  
Neonatal Hyperbilirubinemia ◽  
Control Group ◽  
Abo Incompatibility ◽  
Healthy Infants ◽  
Significant Depression ◽  
Immunological Factors ◽  
Antibody Levels

Twelve infants with neonatal hyperbilirubinemia caused by Rh or ABO incompatibility were followed for 1 year after birth. Antibodv determinations for diphtheria, tetanus, pertussis and three strains of E. coil (026, 055, and 079) were done. The results were compared with those from a control group of 25 healthy infants and from 40 infants who had received exchange transfusion after birth. The data suggests that bilirubin is a causative factor in the significant depression of antibody levels against diphtheria, tetanus, and pertussis in infants with hyperbilirubinemia when compared to healthy infants. [see pdf for figures]

The Clinical Spectrum of ABO Incompatibility and Hemolytic Disease in the Newborn

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 1182-1182 ◽  
Author(s):  
Latha B. Rao ◽  
Zohaib Ahmed ◽  
Bulent Ozgonenel
Keyword(s):  
Cord Blood ◽  
Hemolytic Anemia ◽  
Conflicts Of Interest ◽  
Strong Association ◽  
Antigen Expression ◽  
Hemolytic Disease ◽  
Abo Incompatibility ◽  
Clinical Events ◽  
Increased Risk ◽  
Rh Incompatibility

Abstract Abstract 1182 Introduction: ABO hemolytic disease of the newborn occurs almost exclusively in infants of blood group A or B who are born to group O mothers. Although ABO incompatibility is common, its related hemolytic disease has been reported to be low. In this study, we aimed to investigate the rate of direct anti-globulin test (DAT) positivity and clinical events, such as hyperbilirubinemia or anemia in infants born to group O mothers. Methods: Using the charge code for cord blood evaluation, we were able to identify all cord blood evaluations from January 1, 2006 - December 31, 2007, and then select out the ABO incompatible births from group O mothers. We then reviewed the electronic medical records for demographic, clinical and laboratory information. Clinical events (anemia, jaundice, hemolytic disease) were investigated only in babies born at 37 weeks or higher gestation. Chi-square tests were used to cross-tabulate clinical events, demographic parameters (gender, ethnicity), and laboratory parameters (AO versus BO incompatibility, DAT-positivity). Results: There were 10,891 live births during the two-year period and 1519 (14%) of these were ABO incompatible. ‘Black’ ethnicity was registered in 80% of these babies. AO and BO incompatibility comprised 57.8% and 42.2% of the cases, respectively. 5.3% of the cases had concomitant Rh incompatibility. DAT was positive in 16.7% of the cases: 13.8% weakly or 1+ positive, and 2.9% 2+ or 3+ positive. DAT was more commonly positive among BO-incompatible cases compared to AO-incompatible cases (21.7% versus 13.1%). Among blacks, DAT-positivity in BO incompatibility was more common (24.9% among blacks compared to 7.8% among non-blacks, p<0.001). Concomitant Rh incompatibility did not affect DAT positivity rate. Among AO-incompatible babies, DAT-positivity was more frequent among females (15.5% in females vs 10.8% in males, p=0.045). 1299 babies were born at term (3 37 weeks gestation).of these infants, hyperbilirubinemia (defined as indirect bilirubin 3 8 mg/dL) was detected in 17.3% of babies. This was significantly associated with DAT positivity (40.6% in DAT-positive cases vs 12.3% in DAT-negative cases, p<0.001) and BO incompatibility (p=0.001). Hemolytic anemia (defined as hematocrit £ 45% and reticulocyte count 3 250,000/mm3 in the first week of life) was noted in 3.4% of cases, and was significantly associated with DAT positivity (13.2% in DAT-positive cases vs 1.1% in DAT-negative cases, p<0.001); BO incompatibility (p=0.001); and black ethnicity (p=0.001). Discussion: Our study indicated that cord blood DAT was positive in 16.7% of ABO incompatible pregnancies. BO-incompatible cases were more likely to be DAT-positive in blacks. AO-incompatibility was more common among girls, consistent with earlier studies that had shown a stronger A antigen expression among female newborns. DAT-positive cases were more likely to develop hyperbilirubinemia or hemolytic anemia. In addition, black ethnicity and BO incompatibility conferred significantly increased risk of hemolytic anemia in our study. Despite this strong association, the sensitivity of the positive DAT was 41.3% for hyperbilirubinemia and 70.5% for hemolytic anemia in ABO incompatibility. Disclosures: No relevant conflicts of interest to declare.

scholarly journals A Study of Neonatal Hyperbilirubinemia in Mid-Western Part of Nepal

2017 ◽  
Vol 15 (2) ◽  
pp. 41-43 ◽  
Author(s):  
K.M. Roma ◽  
Piush Kanodia ◽  
Manita Pyakurel ◽  
Veena Gupta
Keyword(s):  
Neonatal Jaundice ◽  
Hospital Admissions ◽  
Serum Bilirubin ◽  
Study Data ◽  
Neonatal Hyperbilirubinemia ◽  
Treatment Modalities ◽  
Total Serum ◽  
Common Cause ◽  
Abo Incompatibility ◽  
Satisfactory Outcome

Introduction: Neonatal hyperbilirubinemia is a common cause of hospital admissions. Serum Bilirubin depends on birth weight and gestational age. Common causes of neonatal jaundice are physiological jaundice, breast feeding/milk jaundice, prematurity and pathological causes. Surmount total serum bilirubin over critical level, crosses the blood brain barrier leading to kernicterus. Prompt identification and proper management is of great importance otherwise there is a risk of bilirubin encephalopathy. Objectives: To find out the prevalence and causes of neonatal jaundice in our setting and treatment modalities undertaken. Materials and methods: A hospital based descriptive study was done among total newborns including both inborn and out born admitted in NICU, NGMC over the period of one year. A total 288 newborns with jaundice were enrolled in the study .Data were entered in excel and th analyzed in SPSS 18 version. Descriptive data were presented through pie, bar graph, and table with frequency and percentage. Results: Prevalence of neonatal jaundice was 31%. Causes of neonatal jaundice were physiological and pathological in 56% and 44% cases respectively. Among the pathological causes ABO incompatibility was the most common cause seen in 11.4% cases followed by sepsis seen in 8.7% cases. Conclusions: Phototherapy is very effective treatment modality to reduce the serum bilirubin in most of the cases neonatal hyperbilirubinemia and if the bilirubin crosses the cut off limit according to Bhutani's chart then we have to consider exchange transfusion. Appropriate management in time leads to satisfactory outcome.

scholarly journals Study of clinical spectrum of hyperbilirubinemia with frequency of glucose six phosphate dehydrogenase deficiency in neonates

2021 ◽  
Vol 9 (6) ◽  
pp. 1674
Author(s):  
Keshawati Goel ◽  
Anshuman Srivastava
Keyword(s):  
G6pd Deficiency ◽  
Prospective Observational Study ◽  
Dehydrogenase Deficiency ◽  
Uttar Pradesh ◽  
Neurological Deficits ◽  
Medical College ◽  
Abo Incompatibility ◽  
Mucous Membranes ◽  
Rh Incompatibility ◽  
Breast Fed

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.

Letter to the Editor

PEDIATRICS ◽  
1972 ◽  
Vol 50 (1) ◽  
pp. 169-169
Author(s):  
Jane Desforges
Keyword(s):  
Red Cells ◽  
Hemolytic Disease ◽  
Left Behind ◽  
Abo Incompatibility ◽  
Letter To The Editor ◽  
Rh Incompatibility

In hemolytic disease, it is always difficult to comment on the properties of red cells which have already been removed from the circulation. One can only study those left behind and presumably, therefore, less injured. However, with the mechanism of immunohemolysis in Rh incompatibility as a prototype, one can propose hemolytic disease of the newborn in ABO incompatibility to be related to a coating antibody which is not complement dependent, rather than to the hemolysin.

STUDIES ON ERYTHROBLASTOSIS DUE TO ABO INCOMPATIBILITY

PEDIATRICS ◽  
1954 ◽  
Vol 13 (6) ◽  
pp. 503-510
Author(s):  
DAVID YI-YUNG HSIA ◽  
SYDNEY S. GELLIS
Keyword(s):  
Blood Group ◽  
Bilirubin Level ◽  
Serum Bilirubin ◽  
Laboratory Data ◽  
Serum Bilirubin Level ◽  
Present Knowledge ◽  
Coombs Test ◽  
Abo Incompatibility ◽  
Rh 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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