Abstract
BACKGROUND Haemolytic Disease of Fetus and Newborn (HDFN) is characterised by lysis of red blood cells resulting in anaemia and its hypoxic effects thereafter. Following anaemia, the production of fetal red blood cells is drastically increased. This is followed by extramedullary haematopoiesis in a widespread manner and erythroblastosis characterized by nucleated red cells in the circulation. Since this is an illness affecting many a newborn, assessing the patterns of anaemia in both ABO and Rh-D HDFN may help in effective planning and implementation of better management protocols. METHODS This is a cross sectional study with comparative analysis. The study was performed among 154 neonates who were diagnosed to have HDFN. Setting for this study was Department of Transfusion Medicine and Pediatrics of Government Medical College, Trivandrum. During the time of delivery, 5 mL umbilical cord blood was collected. That sample was used for analyzing haemoglobin levels of the neonate. Duration of treatment of the neonate was noted down during follow up. Statistical analysis was done using SPSS software version 16. RESULTS The mean cord blood haemoglobin value in ABO haemolytic disease was 17.1 ± 2.7 g %. The mean cord blood haemoglobin value in Rh-D haemolytic disease was 14.5 ± 1.9 g %. In infants with ABO haemolytic disease, 53 (48.2 %) had undergone no treatment in ICU. Remaining 51.8 % had undergone 3 - 10 days of treatment in neonatal ICU. Infants with Rh-D HDFN 20 (45.5 %), had undergone no treatment in ICU. Remaining 54.5 % has got 3 - 9 days of treatment in neonatal ICU. Mean treatment duration in infants with ABO haemolytic disease was 3.1 ± 3.3 days. Mean treatment duration in infants with Rh-D haemolytic disease was 2.9 ± 2.9 days. A comparison of mean values of cord blood haemoglobin in neonates with both categories of haemolytic disease was performed. The p value was 0.00 and it was significant. Mean values of duration of treatment of neonates with ABO and Rh-D haemolytic anaemias were compared statistically. No significant difference was observed. CONCLUSIONS Mean haemoglobin levels in Rh-D HDFN showed a significant decrease as compared to ABO-HDFN. Duration of treatment in ABO HDFN and Rh-D HDFN presented no significant difference. KEYWORDS Haemolytic Disease of Fetus and Newborn, Umbilical Cord Haemoglobin, Anaemia, ICU Stay, ABO HDFN, Rh-D HDFN
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