Severe neonatal hyperbilirubinemia in the south-east region of Turkey (original) (raw)

The etiology of severe neonatal hyperbilirubinemia and complications of exchange transfusion

The Turkish journal of pediatrics

Exchange transfusion (ECT) has an important role in preventing kernicterus in the treatment of indirect hyperbilirubinemia of the newborn. In present study, the etiology of hyperbilirubinemia and complications of ECT were studied over a five-year period in the Eastern Mediterranean region of Turkey. We describe our experience of 89 ECTs performed from 2003-2008 in 79 newborns with hyperbilirubinemia. The mean gestational age was 37 +/- 2.1 weeks and the mean of peak total bilirubin levels was 28.1 +/- 6.4 mg/dl. The most common cause of hyperbilirubinemia was ABO isoimmunization (38%). Complications of ECT developed in 17 neonates (21.5%), the most common being thrombocytopenia and seizure. None of newborns died secondary to ECT. Our data showed higher morbidity rates associated with ECT in the treatment of hyperbilirubinemia in our region. In order to prevent adverse effects of ECT, serum bilirubin levels should be closely monitored in newborns with ABO immunization.

Evaluation of Risk Factors for Exchange Range Hyperbilirubinemia in Neonates from Eastern Part of Nepal

Journal of Nepal Paediatric Society, 2021

Introduction: Neonatal hyperbilirubinemia continues to be the commonest cause of nursery and NICU admissions and readmissions in the neonatal period worldwide. Although most cases are physiological, toxic levels of un-conjugated bilirubin can lead to acute and chronic bilirubin encephalopathy. Hence, this study aimed to study the risk factors for exchange range hyperbilirubinemia in neonates. Methods: This was a hospital-based prospective observational study conducted in a teaching and referral NICU over a period of one year from July 2019 to August 2020. All neonates with diagnosis of hyperbilirubinemia requiring double volume exchange transfusion were included in the study. Risk factors for significant hyperbilirubinemia were analysed with descriptive statistics. P-value of < 0.05 was considered significant wherever applicable. Results: The mean gestational age and birth weight were 38.06 ± 2.13wks and 2611.72 ± 389.39 gm respectively. Fifteen percent of the babies (162) develo...

Outcomes of rescue exchange transfusion in severe neonatal hyperbilirubinemia Şiddetli neonatal hiperbilirubinemide kurtarma değişimi transfüzyonunun sonuçları

2022

Öz Purpose: Urgent treatment in newborns with severe hyperbilirubinemia is the removal of bilirubin from the body by exchange transfusion (ET) as the main treatment modality. The aim of this study was to evaluate the outcomes of newborns with severe hyperbilirubinemia who underwent ET in two neonatal ıntensive care units (NICUs). Materials and Methods: The clinical data were collected of 28 newborns who had undergone rescue exchange transfusions after hospitalization with a diagnosis of severe hyperbilirubinemia in NICUs of a university hospital and a state hospital. Results: Evaluation was made of 28 newbons with a median serum bilirubin level on admission of 31.2 (20.336.8) mg/dL. The leading cause for exchange transfusion was hemolytic jaundice (67.8%), followed by inadequate feeding (14%). The most common cause of hyperbilirubinemia was Rh incompatibility. The reported rate of adverse events associated with exchange transfusion was 71%. The most common complications due to ET we...

Severe neonatal hyperbilirubinemia leading to exchange transfusion

Medical journal of the Islamic Republic of Iran, 2014

Severe neonatal hyperbilirubinemia is associated with significant morbidity and mortality. This study was conducted to investigate the causes of severe hyperbilirubinemia leading to Exchange Transfusion (ET) from March 2009 to March 2011 in Bahrami children hospital, Tehran, Iran in order to establish guidelines to prevent profound jaundice & ET. 94 neonates underwent ET for severe hyperbilirubinemia data for demographic data, and onset of jaundice, history of severe hyperbilirubinemia in siblings, blood group of both mother and neonate, G6PD activity, hemoglobin, hematocrite, reticulocyte count, peripheral blood smear, total and direct bilirubin before and after ET, direct and indirect Coombs, times of transfusion and the cause of hyperbilirubinemia were all recorded for analysis. Ninety four neonates (56.4% boys and 43.6% girls) underwent ET with a mean birth weight of 1950±40 g and a mean gestational age of 35.2±1.4 weeks. Premature labor, breastfeeding jaundice, ABO incompatibil...

Determination of Hematologic Causes of Hyperbilirubinemia in Neonates Undergoing Exchange Transfusion in South West of Iran

Pakistan pediatric journal

Purpose: The aim of this study was to find G6PD, Rh incompatibility, and ABO incompatibility among neonates with severe hyperbilirubinemia who underwent underwent exchange transfusion. Materials and Methods: Records of all (131) neonates who underwent exchange transfusion between 2006 and 2009 at two hospitals in Ahvaz- Iran, were reviewed. Collected data included age, sex, weight, total and direct bilirubin levels, direct Coombs test results, haemoglobin levels, haematocrit and G6PD qualitative test findings. Patients were classified into two groups: a normal enzyme group and a group with deficient activity of G6PD. All data were analyzed with statistical tests using SPSS ver 13.0 (Chicago, IL, USA). Results: Of 1,970 neonates admitted due to jaundice, 131(6.6%) cases required exchange transfusion; the total number of exchange transfusions was 168. The factors necessitating exchange transfusion were undetermined in 51(38.9%) neonates while G6PD deficiency was the most common known ...

Exchange Transfusion for Hyperbilirubinemia among Term and Near Term in NICU of a Tertiary Care Hospital of Bangladesh: Findings from a Prospective Study

Euroasian Journal of Hepato-Gastroenterology

Background: Exchange transfusion in newborns is recommended as emergency management of hyperbilirubinemia to prevent bilirubin encephalopathy and kernicterus. Aim: This study aimed to determine the frequency and document common side effects of exchange transfusion and outcomes of newborns requiring exchange transfusion. Materials and methods: This prospective study was done in the Neonatal Intensive Care Unit (NICU) of Bangabandhu Sheikh Mujib Medical University (BSMMU), Bangladesh, from January 2016 to December 2019. Information was obtained regarding maternal details, newborn demographics, and clinical status. Blood grouping and Rh typing were done for both mothers and newborns. In all newborns, pre-exchange complete blood count, peripheral blood film, Coombs test, reticulocyte count, serum bilirubin and post-exchange serum bilirubin, hemoglobin, random blood sugar, serum electrolyte, and calcium were done. G6PD level was done wherever suspected. Frequency, maternal and neonatal factors, indications, and outcomes were analyzed. Results: Among 839 admitted cases of unconjugated hyperbilirubinemia, 41 patients (4.9%) required exchange transfusion. Most of the babies were inborn (90.2%). Ninety-five percent of mothers received regular antenatal care; among them, 76.3% had bad obstetric history. Only 36.6% of mothers received anti-D in previous pregnancy. None had sonographic findings of hydrops. The commonest indication was Rh incompatibility (80.5%). Coombs test was positive in 58.5% of cases. Mean pre-exchange TSB was 9.44 ± 6.4, and post-exchange TSB was 4.41 ± 2.59. The commonest adverse events noted were hyperglycemia (51.2%), sepsis (19.5%), anemia requiring top-up transfusion (17.1%), and hypocalcemia (14.6%). There were no catheter-related complications. Bilirubin encephalopathy was present in 4.9% of cases. There was one mortality but not due to the procedure. Conclusion: Exchange transfusion was required among 4.9% of the admitted newborns with unconjugated hyperbilirubinemia. The common adverse effects were hyperglycemia and sepsis. The commonest indication was Rh incompatibility (80.5%). Overall outcome after exchange transfusion was favorable.