Clinico-etiological profile of neonates with neonatal hyperbilirubinmemia treated with double volume exchange transfusion

Authors

  • Naseer Y. Mir Department of Pediatrics, Government Medical College, Handwara, Jammu and Kashmir, India
  • Irtika Department of Obstetrics and Gynecology, Government Medical College, Srinagar, Jammu and Kashmir, India
  • Bashir U. Zaman Department of Pediatrics, Government Medical College, Srinagar, Jammu and Kashmir, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20241680

Keywords:

Double volume exchange transfusion, Neonatal hyperbilirubinemia, Rh incompatibility

Abstract

Background: Neonatal hyperbilirubinemia continues to be the most common cause of hospital admissions and readmissions in the neonatal population worldwide and this pattern continues despite attempts to identify neonates at risk of pathological hyperbilirubinemia. The aim of the study was to determine the clinical profile and etiology in neonates who were treated with double volume exchange transfusion (DVET).

Methods: This was a hospital based prospective observational study in neonates ≥35 weeks of gestation who were treated with DVET for severe hyperbilirubinemia in a tertiary care centre over a period of six months.

Results: In our study 110 neonates with severe hyperbilirubinemia were treated with DVET. Majority of the neonates were males (59.1%). Lower segment caesarean section (LSCS) was the common mode of delivery observed in 66.4% of the study subjects. Rh incompatibility (36.4%) was the commonest cause of exchange transfusion followed by ABO incompatibility (20%). The mean age of neonates at admission and mean age at DVET in days were 4.03±2.46 and 4.25±2.44 respectively. The mean birth weight of neonates treated with DVET was found to be 2.81±0.57. The mean total serum bilirubin at pre-exchange and post exchange were 26.13±6.58 mg/dl and 11.63±3.24 mg/dl respectively.

Conclusions: Rh incompatibility was the most common cause in neonates with severe hyperbilirubinemia requiring double volume exchange transfusion.

Metrics

Metrics Loading ...

References

Maisels MJ, Kring E. Length of stay, jaundice, and hospital readmission. Pediatrics. 1998;101(6):995-8.

Jardine LA, Woodgate P. Neonatal jaundice. Am Fam Physician. 2012;85(8):824-5.

Bhutani VK, Johnson LH, Keren R. Diagnosis and management of hyperbilirubinaemia in the term neonate: for a safer first week. Pediatr Clin North Am. 2004;51:843-61.

Ip S, Chung M, Kulig J, O’Brien R, Sege R, Glicken S, et al. An evidence-based review of important issues concerning neonatal hyperbilirubinaemia. Pediatrics. 2004;114(1):130-53.

Brown AK, Damus K, Kim MH. Factors relating to readmission of term and near-term neonates in the first two weeks of life. Early Discharge Survey Group of the Health Professional Advisory Board of the Greater New York Chapter of the March of Dimes. J Perinatal Med. 1999;27(4):263-75.

Johnson L, Bhutani VK. The clinical syndrome of bilirubin-induced neurologic dysfunction. Semin in Perinatol. 2011;35(3):101-13.

Olusanya BO, Ogunlesi TA, Slusher TM, Why Kernicterus is still a major cause of death and disability in low-income and middle-income countries Arch Dis Child. 2014;99(12):1117-21.

American Academy of Pediatrics, Subcommittee on hyperbilirubinemia. Management of hyperbilirubinemia in the newborn infant 35 weeks or more gestation. Pediatrics. 2004;114:297-316.

Newman TB, Maisels MJ. Evaluation and treatment of jaundice in the term newborn: a kinder, gentler approach. Pediatrics. 1992;89(5Pt1):809-18.

Steiner LA, Bizzarro MJ, Ehrenkranz RA, Gallagher PG. A decline in the frequency of neonatal exchange transfusions and itseffect on exchange related morbidity and mortality. Pediatrics. 2007;120(1):27-32.

Behjata S, Sagheb S, Aryasepehr S, Yaghmai B. Adverse events associated with neonatal exchange transfusion for hyperbilirubinaemia. Indian J Pediatr. 2009;76:83-5.

12. Davutoğlu M, Garipardiç M, Güler E, Karabiber H, Erhan D. The etiology of severe neonatal hyperbilirubinemia and complications of exchange transfusion. Turk J Pediatr. 2010;52:163‑6.

Chitlangia M, Shah GS, Poudel P, Mishra OP. Adverse events of exchange transfusion in neonatal hyperbilirubinemia. J Nepal Paediatr Soc. 2014;34:7‑13.

Sgro M, Campbell D, Shah V. Incidence and causes of severe neonatal hyperbilirubinemia in Canada. CMAJ. 2006;175:587‑90.

Mac Donald MG, Mullet MD, Seshia MM, editors. Avery’s Neonatology Pathophysiology and Management of the Newborn. 6th ed. Philadelphia: Lippincott Williams & Wilkins. 2005;775.

Murki S, Kumar P, Majumdar S, Marwah N, Narang A. Risk factors for Kernicterus in neonates with non-hemolytic jaundice. Indian Pediatric. 2001;38(7):757-62.

Manning D, Todd P, Maxwell M, Platt MJ. Prospective surveillance study of severe hyperbilirubinemia in the newborn in the UK and Ireland. Arch Dis Child Fetal Neonatal Ed. 2007;92(5):342-6.

Bhat WA, Churoo BA, Iqbal Q, Sheikh MA, Iqbal J, Aziz R. Complication of exchange transfusion at a tertiary care hospital. Curr Pediatr Res. 2011;15:97‑9.

Badiee Z. Exchange transfusion in neonatal hyperbilirubinaemia: Experience in Isfahan, Iran. Singapore Med J. 2007;48:421‑3.

Dikshit SK, Gupta PK. Exchange transfusion in neonatal hyperbilirubinemia. Indian Pediatr. 1989;26:1139‑45.

Narang A, Gathwala G, Kumar P. Neonatal jaundice: An analysis of 551 cases. Indian Pediatr. 1997;34:429‑32.

Shah A, Shah CK, Shah V. Study of hematological parameters among neonates admitted with neonatal jaundice. J Evol Med Dent Sci. 2012;1:203‑8.

Downloads

Published

2024-06-26

How to Cite

Mir, N. Y., Irtika, & Zaman, B. U. (2024). Clinico-etiological profile of neonates with neonatal hyperbilirubinmemia treated with double volume exchange transfusion. International Journal of Contemporary Pediatrics, 11(7), 941–944. https://doi.org/10.18203/2349-3291.ijcp20241680

Issue

Section

Original Research Articles