Abstract
<p><strong>Objective:</strong><strong>  </strong>To determine the effect of phototherapy on platelet count in neonates having unconjugated hyperbilirubinemia.</p><p><strong>Patients and Methods:</strong><strong>  </strong>This cross sectional study was conducted in the Neonatology unit of a Hospital, Faisalabad during a period of nine months i.e., January to September 2015. All the neonates having unconjugated hyperbilirubinemia and requiring phototherapy with normal initial platelet count were included in the study. Platelet count was evaluated before the start of phototherapy and then during phototherapy at 24 hrs, 48 hrs and 72 hrs interval. Platelet counts were compared after 24, 48 and 72 hours of phototherapy. P value &lt; 0.05 was considered significant.</p><p><strong>Results:</strong><strong>  </strong>Total 150 newborns having unconjugated hyperbilirubinemia were included with mean age of 3.95 ± 1.71days. After 24 hours of phototherapy, about 8.1% of the patients were having severe thrombocytopenia (platelet count &lt; 50 ×10<sup>9</sup>/L); this percentage rose to 18.4% after 48 hours and 33.3% after 72 hours of phototherapy. None of the patients developed clinical manifestation of bleeding. The number of patients with normal platelet count (1,50 × 10<sup>9</sup>/L – 400 × 10<sup>9</sup>/L) after 24 hours of continuous phototherapy was 50%, gradually reducing  to 38% after 48 hours and only 33% after 72 hours of completion of phototherapy(p value &lt; 0.05).</p><p><strong>Conclusion:</strong><strong>  </strong>Hyperbilirubinemic neonates undergoing phototherapy had a fall in platelet count without any clinical manifestation of bleeding.</p><p> </p>
Highlights
Neonatal jaundice due to unconjugated perbilirubinemia is quite common condition that affects about 60% of term and 80% of preterm infants during first week of life.[1,2] Once unconjugated hyperbilirubinemia crosses the upper limits of physiological jaundice, it may be harmful for the brain
In our study total 124 newborns having unconjugated hyperbilirubinemia were included with mean age of 3.95 ± 1.71 days
After continuing the phototherapy for 24 hours, about 8.1% of the patients were having severe thrombocytopenia, the number gradually rose to 18.4% after 48 hours and 33.3% after 72 hours of phototherapy. (P value < 0.05)
Summary
Neonatal jaundice due to unconjugated perbilirubinemia is quite common condition that affects about 60% of term and 80% of preterm infants during first week of life.[1,2] Once unconjugated hyperbilirubinemia crosses the upper limits of physiological jaundice (unconjugated serum bilirubin level 5 – 6 mg/dl), it may be harmful for the brain. Bilirubin encephalopathy may affect brain resulting in permanent developmental delay.[3] Treatment options available for unconjugated hyperbilirubinemia include phototherapy, exchange transfusion, IV immunoglobulins and metalloporphyrin. Out of these options, phototherapy which is a noninvasive technique has been used widely for the treatment of neonatal jaundice. Phototherapy is being considered world wide as first line treatment for neonatal Jaundice.[5]
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