scholarly journals Can Phototherapy Requirements Be Predicted through Cord Blood Test Results in Newborns?

2020 ◽  
pp. 99-102
Author(s):  
Berna Hekimoğlu
Keyword(s):  
Cord Blood ◽  
Bilirubin Level ◽  
Early Discharge ◽  
High Rate ◽  
Coombs Test ◽  
Direct Coombs Test ◽  
Abo Incompatibility ◽  
Permanent Brain Damage ◽  
Positive Direct

Objective: Hyperbilirubinemia is one of the common problems in newborns. If not diagnosed and treated in time, high bilirubin levels can cause kernicterus and permanent brain damage. Therefore, early detection of hyperbilirubinemia development risk in newborns is important. Our aim is to determine whether the cord blood bilirubin level and the direct coombs test can be used as determinant parameters in order to predict babies with a high risk of developing hyperbilirubinemia requiring treatment. Material and Method: During the process of creating a hyperbilirubinemia follow-up protocol at Ordu University Training and Research Hospital, 300 babies born between January -June 2014with a birth weight ≥ 2500 g and gestational week ≥ 37 weeks were included in the study. The results of the cord blood bilirubin in of these babies, direct coombs test, maternal and infant blood groups and serum bilirubin levels of those who were hospitalized for phototherapy treatment within the first 24 hours were analyzed retrospectively. Results: Phototherapy was given to 35 of 300 (11.7%) newborns included in the study within the first 24 hours after birth. Direct coombs test was positive in 25 of them (8.3%). Phototherapy was given to 80% (n: 20) of the cases whose direct coombs test was positive. ABO incompatibility was found in the etiology of 51.5% of the cases with hyperbilirubinemia. It has been observed that patients with positive direct coombs test have a high rate of hospitalization (p<0.001). Cord blood bilirubin levels were found to be statistically higher in cases who received phototherapy (2.7±1.0 and 1.8±0.6, respectively, p<0.01). In determining the need for phototherapy, sensitivity was 77.1%, specificity was 77.0%, and negative predictive value was 96% for the cut off value of 2.0 mg/dl of cord blood bilirubin. Conclusion: Cord blood bilirubin level and direct coombs test are useful in predicting the possibility of pathological hyperbilirubinemia and hospitalization in newborns. Thus, detection of risky newborns with a noninvasive method within a few hours after birth will prevent early discharge and provide close follow-up and early treatment.

scholarly journals Coombs test positivity in cord blood: early detection of risky newborns and the assessment of their follow-up results

2021 ◽  
Vol 28 (1) ◽  
pp. 42-47
Author(s):  
Ali Ulaş Tuğcu ◽  
Faika Ceylan Çiftçi ◽  
Esra Aktepe Keskin
Keyword(s):  
Risk Factors ◽  
Cord Blood ◽  
Hemolytic Anemia ◽  
Demographic Data ◽  
Early Period ◽  
Serum Total Bilirubin ◽  
Specific Method ◽  
Coombs Test ◽  
Direct Coombs Test

Objective Direct Coombs test (DCT) is a screening process to detect antibodies which are produced against the antigens in the red blood cells of newborns and cause hemolytic disease. In our study, we aimed to compare the demographic data and early period outcomes of the newborns with and without DCT positivity. Methods The data of all newborns who were born in our hospital between January 2019 and September 2019, of whose mothers gave informed consent before the labor and whose cord blood samples were examined were reviewed retrospectively. The data were analyzed by using SPPS 25 (IBM Corp. Released 2017; IBM SPSS Statistics for Windows, Version 25.0; IBM Corp., Armonk, NY, USA) statistics software. Results A total of 302 newborns were included in the study. The results of Direct Coombs test were positive in 27 cases. The phototherapy rate of the cases with positive DCT results was 74% (20/27). It was found that the cases with positive DCT results underwent more phototherapy, started to undergo phototherapy earlier, were hospitalized longer and had lower serum total bilirubin levels compared to the cases with negative DCT results, and these differences were statistically significant (p=0.003, p=0.015, p=0.038 and p=0.026, respectively). Conclusion Today, there is no specific method to prevent jaundice particularly for the newborns with a risk factor. The only thing to do for newborns at this point is to detect if they have risk factors or not, and to follow up newborns with risk factors appropriately. Direct Coombs test has still been playing an important role to predict hemolytic anemia and potential manifestation of hyperbilirubinemia in association with hemolytic anemia in the newborns, and to initiate treatment process as soon as possible.

Hospital Readmission Due to Neonatal Hyperbilirubinemia

PEDIATRICS ◽  
1995 ◽  
Vol 96 (4) ◽  
pp. 727-729 ◽  
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 &gt;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 &gt;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 &lt;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.

scholarly journals AB0007 STAT4 RS7574865 G/T POLYMORPHISM AS MARKER OF PREDISPOSITION TO SYSTEMIC LUPUS ERYTHEMATOSUS WITH JUVENILE ONSET

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1038.2-1039
Author(s):  
M. Kaleda ◽  
M. Krylov ◽  
I. Nikishina
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Pilot Study ◽  
Lupus Erythematosus ◽  
Renal Involvement ◽  
Control Group ◽  
Coombs Test ◽  
Systemic Lupus ◽  
Direct Coombs Test ◽  
Positive Direct ◽  
Cutaneous Lupus

Background:Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with a significant genetic predisposition. Recent studies have identified STAT4 (signal transducers and transcription activators 4) as a susceptibility gene for SLE.Objectives:To investigate the hypothesis of the association of STAT4 rs7574865 G/T polymorphism with the predisposition to SLE in children and its relationship with some of SLE manifestations.Methods:The case-control pilot study included 143 children (39 with SLE and 103 healthy unrelated volunteers as a control group). Diagnosis of SLE was based on 2012 SLICC criteria. STAT4 rs7574865 G/T polymorphism was investigated using allele-specific real-time polymerase chain reaction (RT-PCR).Results:The group of pts with SLE consisted of 29 girls and 10 boys, with an average age of 11.8±3.7 years (from 3 to 17 years) and an average disease duration of 4.1±2.4 years. 79.5% pts had acute cutaneous lupus at the onset, 46.1% - nonscarring alopecia, 71.8% - arthritis, 23.1% - oral and nasal ulcers, 23.1% - serositis, 43.6% - renal involvement, 35.9% –neuropsychiatric disorders. Leucopenia/lymphopenia was found in 71.8% of pts, thrombocytopenia – in 23,1%. ANA were detected in 100% pts, anti-dsDNA – in 79.5%, anti-Sm – in 31.6%, antiphospholipid antibodies - in 7,3%, hypocomplementemia – in 61.5%, positive direct Coombs test – in 35.9 %. Macrophage activation syndrome at the onset was documented in 15.4 % of pts. The distribution of rs7574865 genotypes in the control group showed no significant deviations from the Hardy-Weinberg equilibrium. The distribution of genotype frequencies among pts had statistically significant differences compared to the control (χ2=12.95, p=0.0015): GG-30.8% and 63.1% (p=0.001), GT-56.4% and 33.0% (p=0.018), TT-12.8% and 3.9% (p=0.114), GT+TT - 69.2% and 36.9% (p=0.0005). The frequency of the mutant STAT 4 allele T (polymorphism), was significantly higher in the SLE group than in the control group (41% and 20.4%, respectively; p=0.0007). We identified an association of the T allele with some clinical, laboratory, and immunological disorders in SLE: arthritis (OR 3.9, p=0.0002), acute cutaneous lupus (OR 2.47, p=0.003), nonscarring alopecia (OR 3.12, p=0.002), renal involvement (OR 2.42, p=0.022), leucopenia (OR 2.72, p=0.003), thrombocytopenia (OR 4.88, p=0.002), anti-dsDNA (OR 2.82, p=0.0006), hypocomplementemia (OR 2.34, p=0.012), positive direct Coombs test (OR 3.38, p=0.002).Conclusion:Our pilot study confirmed that the STAT4 rs7574865 G/T polymorphism was associated with the risk of SLE in children and some of SLE manifestations.Disclosure of Interests:None declared

Positive Direct Coombs' Test Induced by Various Azo Dyes.

1965 ◽  
Vol 119 (4) ◽  
pp. 970-975
Author(s):  
L. M. Norlind ◽  
E. M. Boehni ◽  
D. V. Brown
Keyword(s):  
Azo Dyes ◽  
Coombs Test ◽  
Direct Coombs Test ◽  
Positive Direct

Prognostic Impact of Positive Direct Coombs Test in Chronic Lymphocytic Leukemia (CLL)

2017 ◽  
Vol 17 ◽  
pp. S298
Author(s):  
Mostafa F. Mohammed Saleh ◽  
Shimaa Abdelallah ◽  
Mai M. Aly ◽  
Ghada Elsayed ◽  
Yomna Refaat ◽  
...  
Keyword(s):  
Chronic Lymphocytic Leukemia ◽  
Lymphocytic Leukemia ◽  
Prognostic Impact ◽  
Coombs Test ◽  
Direct Coombs Test ◽  
Positive Direct

scholarly journals Cord blood bilirubin used as an early predictor of hyperbilirubinemia

2018 ◽  
Vol 5 (4) ◽  
pp. 1280
Author(s):  
Kannan Ramamoorthy ◽  
M. S. Abilash
Keyword(s):  
Positive Predictive Value ◽  
Cord Blood ◽  
Negative Predictive Value ◽  
Bilirubin Level ◽  
Predictive Value ◽  
Early Discharge ◽  
Neonatal Hyperbilirubinemia ◽  
Medical College ◽  
Discharge From Hospital ◽  
Early Predictor

Background: Neonatal hyperbilirubinemia is among the commonest symptoms found in neonates. The information about risk of high bilirubin in infants allows simpler methods for reduction of bilirubin to be implemented before hyperbilirubinemia becomes significant and could help to take a decision for early discharge from Hospital. Thus, the authors were aimed at the assessment of the usefulness of the cord blood bilirubin as an early predictor of neonatal hyperbilirubinemia and the usefulness of 1st day bilirubin in predicting the neonatal hyperbilirubinemia.Methods: The present study was planned to conduct in Department of Pediatrics, Government Thiruvarur Medical College and Hospital, Thiruvarur among neonates delivered from 1st August 2011 to 1st December 2013. These neonates were followed from birth to 2nd postnatal day. Cord blood was collected at birth and bilirubin estimation was done within 12 hours of collection of the blood.Results: Cord blood bilirubin level of ≥2.15 mg/dl has a sensitivity of 73.08% and specificity of 59.49%, positive predictive value 14.6% and negative predictive value of 95.88% in predicting the risk of neonatal hyperbilirubinemia. 1st day bilirubin level of ≥5 mg/dl has a sensitivity of 92.3% and specificity of 71.16% and positive predictive value of 23.3% and negative predictive value of 98.9% in predicting the risk of neonatal hyperbilirubinemia.Conclusions: The use of the critical cord bilirubin level of 2 mg/dl in all healthy term newborns will predict significant hyperbilirubinemia.

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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