ERYTHROBLASTOSIS FETALIS<subtitle>VI. Prevention of Kernicterus</subtitle>

CLINICAL CHARACTERISTICS AND MANAGEMENT OF Rh-D HAEMOLYTIC DISEASE OF NEWBORN

“…32 Eugene et al opined that early phototherapy usually reduced or prevented a further rise in serum bilirubin levels and most of the neonates required no transfusions. 33 This research also yielded similar results.…”

Rhesus disease: postnatal management and outcome

“…Their introduction was associated with a reduction in mortality from 19.7% to 11.4% [1]. This positive eect was con®rmed in a randomized trial [33]: 37% of infants who received a``simple'' transfusion died compared to 13% of those who had an exchange transfusion.…”

The rights and wrongs of blood-brain barrier permeability studies: a walk through 100 years of history

“…It is noteworthy that clinicians, who have had to deal with the problem of kernicterus in the newborn for many years, rarely seem to have invoked the state of maturity of the blood-brain barrier in the neonate as a major factor in the occurrence of kernicterus (e.g., Iskander et al, 2014 ), although it has occasionally been mentioned (e.g., Zuelzer and Mudgett, 1950 ; Spiegel-Adolf et al, 1954 ; Ernster et al, 1957 ); rather they developed clinical treatments aimed at reducing the level of unconjugated bilirubin in infants who were at risk: exchange transfusion (Allen et al, 1950 ; Gerrard, 1952 ) barbiturate induction of glucuronyl transferase and phototherapy (Lucey, 1971 ) as well as prevention by immunization of Rh-ve women against the D blood group antigen (Clarke, 1989 ). But the linking of blood-brain barrier immaturity to kernicterus has persisted amongst other groups of scientists and clinicians for decades after Spatz ( 1934 ).…”