Hyperbilirubinemia

Abstract

Background: Neonatal jaundice is a common condition in the early days ofinfant’s life. It clinically manifests in a significant number of full term babies and almost allpremature neonates. Increase in the serum bilirubin during early infancy is multi factorial andmay result in kernicterus. Deposition of unconjugated bilirubin in the brain stem nuclei andbasal ganglion results in permanent brain damage. Objective: To determine the frequencyof common hemolytic causes of hyperbilirubinemia in full term neonates requiring exchangetransfusion. Study Design: Cross-sectional study. Setting: Department of Pediatrics, LadyReading Hospital Peshawar. Period: January to June 2015. Methodology: A total of 449 fullterm neonates requiring exchange transfusion were included in this study on the basis of serumbilirubin level (total, direct, indirect). Hemolytic causes were analyzed by checking blood groups,rhesus factors and measuring glucose 6 phosphate dehydrogenase (G6PD) levels. Results: Inthis study mean age was 10 days with standard deviation ± 1.26. Sixty two percent neonateswere male and 38% were female. Hemolytic causes were analyzed and ABO incompatibilitywas found in 25% neonates, rhesus incompatibility in 15% neonates and G6PD deficiency in32% neonates. Conclusion: In this study, the most common cause of severe jaundice requiringexchange transfusion was G6PD deficiency (33%) with hemolysis.

Risk factors for exchange transfusion in neonates with unconjugated hyperbilirubinemia: A tertiary care hospital study.

“…This deviation may be attributed to factors such as the diagnosis of G6PD deficiency in male neonates, as observed in a study from Peshawar. 18 Effective utilization of phototherapy has been shown to reduce the need for exchange transfusion, a procedure fraught with numerous complications, including hypocalcaemia and hypoglycaemia. Advanced phototherapy machines, such as fiber-optic devices, are being explored as more effective alternatives to conventional phototherapy.…”