Evaluation of cord bilirubin and hemoglobin analysis in predicting pathological jaundice in term babies at risk of ABO incompatibility

Abstract

INTRODUCTIONNeonatal jaundice is the most common condition for which a newborn is admitted and evaluated in NICU. 1 85% of the term and most of the preterm neonates develop hyperbilirubinemia. Also 6.1% of well term newborn have a maximal serum bilirubin level >12.9mg/dl. A serum bilirubin greater than 15mg/dl is seen in 3% of normal full term neonates. 2When early discharges are becoming the rule, readmission are commonly referred after 3 days for the management of jaundice with phototherapy.3 So it becomes all the more important that pathological hyperbilirubinemia is picked up early and treatment started to prevent kernicterus. Biochemical evaluation of total and conjugated bilirubin based on Vanden Bergh reaction is still the gold standard for bilirubin estimation.ABO incompatibility occurs in about 20-25% of pregnancies but severe hemolytic disease develops in only one in ten of such offspring. The exact level of serum bilirubin that can cause brain damage in term and otherwise healthy infant is not predictable. Screening the babies for cord blood bilirubin and hemoglobin is important not only to protect them from kernicterus but ABSTRACT Background: Cord bilirubin and hemoglobin analysis helps not only in predicting the pathological jaundice in ABO incompatibility but also useful for early referral and intervention for better outcome. Aim of this study is to evaluate the cord blood bilirubin and hemoglobin analysis in predicting pathological hyperbilirubinemia in newborn at risk of ABO incompatibility. Methods:In this descriptive study conducted in Government Stanley medical college between January 2016-June 2016, A positive or B positive babies born to O positive mothers with birth weight >2.5 kgs and gestational age >37 weeks were included. A total of 191 babies were studied. Cord bilirubin, reticulocyte count, hemoglobin and fourth day bilirubin were evaluated and data was analysed using Pearson's Chi square and ANOVA. Results: Out of 191 babies, 25 (13%) did not develop any jaundice, 122 (64%) developed physiological jaundice and 44 (23%) had pathological jaundice. The mean cord bilirubin and cord hemoglobin values of newborn who did not develop jaundice were 1.35mg/dl and 15.3g/dl while the values among pathological jaundice were 3.15mg/dl and 14.97g/dl. Conclusions: Babies with cord bilirubin >1.8mg/dl and hemoglobin <15.1gm/dl are more prone for pathological hyperbilirubinemia.

Pengaruh Penerapan Teknologi Big Data, Independensi Auditor, dan Kualitas Pelaporan Keuangan terhadap Efektivitas Proses Audit

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