Abstract

We aimed to determine the role of exchange transfusion related complications, treatment, and etiology as well as subgroup incompatibility in patients subject to ET (exchange transfusion) due to newborn jaundice. 82 patients hospitalized due to newborn jaundice and exposed to exchange transfusion between August 2007 and August 2011 were retrospectively studied. Before ET mean total serum bilirubin was 29,2±9,83. The most frequent cause of ET was ABO incompatibility (31%) followed by Rh incompatibility (19%) and subgroup incompatibility (17%), respectively. In 46% of all patients and in 71% of the patients presenting with subgroup incompatibility , direct combs test was detected to be (+). 49% of the patients were administrated with intravenous immunoglobulin. 5 of the patients who were exposed to ET presented with hydrops fetalis. Of these patients 3 had Rh, 1 had ABO while the other had subgroup incompatibility. Although ABO and Rh incompatibility are substantial underlying reasons of severe jaundice requiring exchange transfusion, particularly widespread use of RhoGAM thereby enabling the prior identification and precautions, ET need was reduced compared to previous cases. On the contrary, SGU related severe hemolytic jaundice relatively enhanced, however.

Highlights

  • Hyperbilirubinemia is one of the most common problems in newborns

  • We retrospectively studied the underlying cause of indirect hyperbilirubinemia, and the etiology, complication and surveillance of the patients undergoing exchange transfusion during 4 years

  • We evaluated patients who were exposed to 89 exchange transfusion procedures due to hyperbilirubinemia in Meram School of Medicine Neonatal Unit between August 2007 and August 2011

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Summary

Introduction

Hyperbilirubinemia is one of the most common problems in newborns. Most of those babies presenting with jaundice do not have any other accompanying problems, potential toxic impacts on central nervous system cause substantial concern. That the earliest and most effective treatment method of indirect hyperbilirubinemia in newborns is exchange transfusion (ET) [1,2,3,4]. ABO and Rh incompatibility are the most common cause of serious indirect hyperbilirubinemia. We retrospectively studied the underlying cause of indirect hyperbilirubinemia, and the etiology, complication and surveillance of the patients undergoing exchange transfusion during 4 years. We tried to work out the role of subgroup incompatibility (SGI)

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