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 Causes of Neonatal Jaundice Requiring Exchange Transfusion

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Hassan Boskabadi ◽  
Gholamali Maamouri ◽  
Maryam Abbasi ◽  
Elahe Heidari
Keyword(s):  
Risk Factors ◽  
Exchange Transfusion ◽  
Neonatal Jaundice ◽  
Serum Bilirubin Level ◽  
Preterm Neonates ◽  
Total Serum ◽  
Cross Sectional ◽  
Abo Incompatibility ◽  
Blood Exchange ◽  
Rh Incompatibility

Background: Neonatal jaundice is highly prevalent in Asia and has serious complications, such as kernicterus. Therefore, it is very important to identify the risk factors of jaundice requiring exchange transfusion since it can be helpful in the prevention of the disease and early diagnosis of its complications. Objectives: The present study aimed to identify the causes of neonatal jaundice requiring blood exchange. Methods: The present cross-sectional study was performed on 251 term and preterm neonates. The studied newborns were 2-14 days old (born at ≥ 35 weeks of gestation) with jaundice and bilirubin of more than 17 mg/dL and received exchange transfusion during 2011 - 2020 in Ghaem teaching hospital, Mashhad, Iran. The required data of the study variables, such as hyperbilirubinemia risk factors, laboratory tests, the documented history of the mothers and neonates, and physical examination results, were collected through a questionnaire and the medical records of the patients. Finally, the collected data were analyzed in SPSS software (version 20). Results: Based on the results, the mean value of the total serum bilirubin level in neonates who received exchange transfusion was 27.53 ± 10.05 mg/dL. The blood types of about 40% of mothers and their neonates were O and A/B, respectively. Moreover, 11.4% of mothers were Rh-negative; however, their neonates were Rh-positive. The results also revealed that the causes of exchange transfusion were unknown, ABO incompatibility, Rh incompatibility, glucose-6-phosphate dehydrogenase deficiency (G6PDD), and sepsis in 52.7 %, 24%, 7.1%, 5.3%, and 5.3% of the neonates, respectively. Conclusions: The findings of this study suggest that after unknown causes, the most common causes of exchange transfusion were ABO incompatibility, Rh incompatibility, G6PDD, and sepsis. Therefore, since most of these causes can be recognized, it is recommended to perform related tests and take related measures in the Midwifery Department of the hospital to prevent the occurrence and exacerbation of jaundice. Moreover, it is recommended to perform an early follow-up after the discharge.

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 Exchange Transfusion: Indication and Adverse Effect

2012 ◽  
Vol 36 (1) ◽  
pp. 16-19 ◽  
Author(s):  
Suraiya Begum ◽  
Md Abdul Baki ◽  
Gopen Kundu ◽  
Imnul Islam ◽  
Manik Kumar Talukdar ◽  
...  
Keyword(s):  
Adverse Effect ◽  
Adverse Events ◽  
Medical Records ◽  
Exchange Transfusion ◽  
Neonatal Jaundice ◽  
Common Complication ◽  
Abo Incompatibility ◽  
Special Care Baby Unit ◽  
Common Causes ◽  
Rh Incompatibility

Objective: To determine the indication and complications of exchange transfusion (ET) performed for neonatal hyperbilirubinaemia. Methods: The medical records of infants < 28 days old who required exchange transfusion (ET) due to neonatal jaundice in Special Care Baby Unit (SCABU), BIRDEM hospital from January 2009 to April 2010 were retrospectively reviewed. Results: Exchange transfusion was performed in 30 neonates during the study period. Indications of exchange transfusion were ABO incompatibility (30.0%), Rh incompatibility (13.3%), septicaemia (6.6%) and in majority causes, were unidentified (50%). Most common complication were thrombocytopenia (33.3%) hyperkalaemia (20%), hypocalcaemia (16.7%) Conclusion: Indication of ET was unidentified in majority cases and among identified cases most common causes was ABO incompatibility. Adverse events were common after exchange transfusion.DOI: http://dx.doi.org/10.3329/bjch.v36i1.13029Bangladesh J Child Health 2012; Vol 36 (1): 16-19

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]

scholarly journals Adverse Events of Exchange Transfusion in Neonatal Hyperbilirubinemia

2014 ◽  
Vol 34 (1) ◽  
pp. 7-13 ◽  
Author(s):  
M Chitlangia ◽  
GS Shah ◽  
P Poudel ◽  
OP Mishra
Keyword(s):  
Adverse Events ◽  
Respiratory Distress ◽  
Exchange Transfusion ◽  
Serum Bilirubin ◽  
Tertiary Care ◽  
Neonatal Hyperbilirubinemia ◽  
Total Serum Bilirubin ◽  
Total Serum ◽  
Bilirubin Encephalopathy ◽  
The Common

Introduction: Jaundice is an important problem during neonatal period. When total serum bilirubin (TSB) level exceeds a critical limit, it crosses the blood brain barrier and results into bilirubin encephalopathy. The main aim of therapy for neonatal hyperbilirubinemia is prevention of bilirubin encephalopathy by phototherapy and/or exchange transfusion. The aims of this study were to evaluate the efficacy of exchange transfusion (ET) and observe the adverse events during and following three days of ET in neonates with hyperbilirubinemia. Materials and Method: Hospital based cross-sectional descriptive study. All neonates admitted to neonatal intensive care unit and /or paediatric wards of a tertiary- care centre between September 2010 to March 2012, requiring ET were enrolled. Results: A total of 139 ETs were performed in 120 neonates. The common causes were ABO incompatibility (30.8%), prematurity (30.8%), idiopathic (27.5%), Rh isoimmunization (6.7%) and cephalhematoma (4.2%). Mean pre- ET total serum bilirubin (TSB) was 24.2 mg% dL. There was 58% reduction in TSB in post ET and 31% net reduction in 6 hr post ET. Term and preterm neonates showed equal percentage of TSB reduction. Respiratory distress (10.8%) and bradycardia (6.7%) were the common adverse events during, and hypocalcemia (98.3%) and thrombocytopenia (34.2%) in 3 days following ET. The sick neonates had significantly higher incidence of thrombocytopenia (p= 0.031), respiratory distress (p=0.009), apnea (p<0.001) and cardiorespiratory arrest (p<0.001). Overall mortality was 4.2%, and non-survivors were mostly low birth weight, born outside the present hospital and had higher incidence of adverse events. Conclusion: Exchange transfusion is an effective intervention in reducing the serum bilirubin level. However, these neonates require monitoring of ionised calcium and thrombocytopenia. Sick neonates had higher incidence of adverse events than healthy and close clinical monitoring is needed to improve the outcome. DOI: http://dx.doi.org/10.3126/jnps.v34i1.9030   J Nepal Paediatr Soc 2014;34(1):7-13

scholarly journals Disease Burden of Neonatal Care Unit at Al-Bayda Medical Center Al-Bayda Libya

2021 ◽  
Vol 36 (4) ◽  
pp. 273-279
Author(s):  
Kamala O. Younis ◽  
Wafa J. Saed
Keyword(s):  
Mortality Rate ◽  
Neonatal Mortality ◽  
Neonatal Jaundice ◽  
Medical Center ◽  
Birth Asphyxia ◽  
Case Fatality ◽  
Neonatal Care ◽  
Normal Vaginal Delivery ◽  
Neonatal Mortality Rate ◽  
Neonatal Care Unit

This research was conducted to determine the number, disease pattern, and outcome of the patients admitted at the Neonatal Care Unit (NCU) at Al-Bayda  medical center (AMC) in Libya. A retrospective cross-sectional descriptive study was carried out on all neonates admitted to the NCU between January 2008 and December 2008. The collected data include age, gender, mode and site of delivery, number of gestations, maturity, duration of stay, cause of admission, and outcome. Total infants delivered were 10075, 620 (6.1%) of them were admitted to NCU with a (6.15%) admission rate, 56.5% were male and 43.5% were female, of whom 613 (98.9%) were inborn and 519 (83.7%) were term neonates; 523 (84.4%) of total born were by normal vaginal delivery (NVD). 48.7% of total admissions occurred during the first 24 hours of life. The average length of hospital stay for term births was 5.6 days (SD 5.4) and for preterm 8.7 days (SD 8.55). The common causes of admission were neonatal jaundice (29.3%), followed by neonatal infections (17.6%) were prematurity accounts for (16.3%), and respiratory distress (11.1%). The majority of the admitted neonates improved and were discharged 517 (83.4%), 37(6%) left against medical advice (LAMA) and nineteen (3%) were referred to other specialized hospitals for further management. The neonatal mortality rate was 0.4%, and the overall hospital neonatal mortality rate was 7.6%. According to the cause-specific death rate analysis, prematurity was the most common cause of death (29.8%), followed by sepsis (17%) and birth asphyxia (12.8%). In conclusion, neonatal jaundice, infection, and prematurity complications were the leading causes of morbidity in neonates. The case-fatality rate was high for prematurity, sepsis, and birth asphyxia. Most of these etiologies are preventable to some extent by regular prenatal visits, healthy delivery practices, and timely referral to hospitals which can reduce NCU burden and improve outcomes

scholarly journals Outcome of Neonatal Hyperbilirubinemia from a Tertiary Care Hospital in Eastern Nepal: A Cross-sectional Study

2021 ◽  
Vol 4 (1) ◽  
pp. 37-42
Author(s):  
Shyam Prasad Kafle ◽  
Mukesh Bhatta ◽  
Ramesh Shrestha ◽  
Sarita Sitaula ◽  
Namu Koirala ◽  
...  
Keyword(s):  
Exchange Transfusion ◽  
Serum Bilirubin ◽  
Cross Sectional Study ◽  
Neonatal Hyperbilirubinemia ◽  
Total Serum Bilirubin ◽  
Total Serum ◽  
Sectional Study ◽  
Cross Sectional ◽  
Bilirubin Encephalopathy ◽  
Poor Outcome

Background: Timely detection and treatment of pathological hyperbilirubinemia in newbornscan prevent acute bilirubin encephalopathy and its consequences. We aimed to identifyitsoccurrence, presentationtime, phototherapyduration, need for exchange transfusion,and outcome. Methods: In this cross-sectional study, we enrolled all the babies admitted for pathological neonatal hyperbilirubinemia in the university hospital ofBPKIHSin a one-yearduration. Babies with life-threatening congenital malformations or conjugated bilirubin >20% of total serum bilirubin or >2 mg/dl were excluded. Obstetric profile of mothers, clinical and laboratory parameters of babies, onset time of pathological jaundice, duration of phototherapy, need for exchange transfusion or intravenous immunoglobulin were recorded. Neonatal outcome was classified as good and poor and its association with potential predictors analyzed.  Results: One-hundred and fifty babiesdeveloped neonatal jaundice requiring treatment. The most common causes includedABO and Rh setting. No cause was found in 26 (18%) babies. One-hundred and eight babies (72%) were only managed withphototherapy whereas 42 (28%) required both phototherapy and double volume exchange therapy. The majority (84.5%) had good outcome without any residual neurological deficit at discharge.Babies with total serum bilirubin >20 mg/dl at presentation, duration of phototherapy >44.8 h, ABO setting, hemolysis, and out born statussignificantly developed poor outcome (p < 0.05). Conclusion: About 15% of the babies with hyperbilirubinemia had acute bilirubin encephalopathy at discharge suggestive of poor outcome. Babies with high bilirubin at presentation, longer duration of phototherapy, ABO settings, hemolysis, and out born statusdeveloped poor outcome.

scholarly journals Clinical profile and aetiological factors of neonatal jaundice from a rural area of Kutch, Gujarat, India

2020 ◽  
Vol 8 (1) ◽  
pp. 143
Author(s):  
Avinash Patel ◽  
Karan Saradava ◽  
Hasmukh Chauhan
Keyword(s):  
Birth Weight ◽  
Neonatal Intensive Care ◽  
Neonatal Jaundice ◽  
Prospective Observational Study ◽  
Medical Science ◽  
Clinical Profile ◽  
Rural Setting ◽  
Abo Incompatibility ◽  
Rh Incompatibility ◽  
Blood Grouping

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.

Sign in / Sign up

Export Citation Format

Share Document