Factors Affecting the Severity of RH Incompatibility Newborn

Abstract

Rh incompatibility is a not common pediatric problem, that cause morbidity and mortality in children, and itis an important cause of hemolysis, anemia and jaundice in newborn. To study Rhesus hemolytic disease, itsseverity, its complications; to evaluate if ABO incompatibility is protective or not, so to find out the efficacyof anti-D globulin ; to evaluate the efficacy of phototherapy and exchange transfusion as a treatment.This study was done on neonates with jaundice, seventy five patients (1-10 days old) who had Rhincompatibility were studied during period from the first of January 2008 to the 30th of June 2008.History was taken about age, gender and gestational age of the patients, determination of gestational ageand hepatosplenomegally as a cause of extramedullary hematopoiesis. Investigations done for patientswere hemoglobin, total serum bilirubin, reticulocyte count, blood group and Rh, and direct coombs test.From 75 patients studied, 55 patients (73%) required treatment for jaundice;25 of them (46%) required onlyphototherapy due to mild degree of hemolysis, and 30 of them (54%) required exchange transfusion withphototherapy due to severe degree of hemolytic. The remaining 20 patients (27%) required observationalone.Family history of previous hemolysis was positive in 44 patients and it was a risk factor for havinghemolysis in present pregnancy. Early evaluation of patients for jaundice was useful in early recovery. ABOincompatibility in association with Rh incompatibility was not necessarily protective against hemolysis. Theadministration of anti-D globulin to the mother within first 72 hours after delivery was protective againstsensitization.Early and proper management of of Rh incompatibility may reduce need for exchange transfusion. ABOincompatibility was not necessarily protective against hemolysis. Anti-D globulin administered to motherswithin 3 days after delivery was protective against sensitization, History of hemolytic in previous siblings isconsidered as a risk factor for present hemolytic in neonates with Rh incompatibility.