Hyperbilirubinemia

Abstract

… Background: Neonatal jaundice is a common condition in the early days of infant's life. It clinically manifests in a significant number of full term babies and almost all premature neonates. Increase in the serum bilirubin during early infancy is multi factorial and may result in kernicterus. Deposition of unconjugated bilirubin in the brain stem nuclei and basal ganglion results in permanent brain damage. Objective: To determine the frequency of common hemolytic causes of hyperbilirubinemia in full term neonates requiring exchange transfusion. Study Design: Cross-sectional study. Setting: Department of Pediatrics, Lady Reading Hospital Peshawar. Period: January to June 2015. Methodology: A total of 449 full term neonates requiring exchange transfusion were included in this study on the basis of serum bilirubin level (total, direct, indirect). Hemolytic causes were analyzed by checking blood groups, rhesus factors and measuring glucose 6 phosphate dehydrogenase (G6PD) levels. Results: In this study mean age was 10 days with standard deviation ± 1.26. Sixty two percent neonates were male and 38% were female. Hemolytic causes were analyzed and ABO incompatibility was found in 25% neonates, rhesus incompatibility in 15% neonates and G6PD deficiency in 32% neonates. Conclusion: In this study, the most common cause of severe jaundice requiring exchange transfusion was G6PD deficiency (33%) with hemolysis.