Analysis of Neonatal Jaundice Requiring Exchange Transfusion
Journal Title: International Journal of Contemporary Medical Research - Year 2017, Vol 4, Issue 8
Abstract
Introduction: Neonatal jaundice, a physiologic condition reflecting the interplay between developmentally modulated changes in bilirubin production and metabolism, affects virtually all newborns. The aim of the study is to determine the etiology of hyperbilirubinemia requiring exchange transfusion and to determine the efficacy of exchange transfusion in our set up. Material and methods: The present prospective study was conducted in a private recognized medical college in the department of pediatrics, Andhra Pradesh during the period September 2009-september2011. The study group consists of 150 neonates who presented with history of jaundice, among them 18 cases required exchange transfusion for treating the hyperbilirubinemia. Pre exchange samples were drawn from peripheral vein or femoral vein, Post Exchange samples were collected from umbilical vein. The samples were analysed for CBP, retic count, coomb’s test, pre and post exchange serum bilirubin and sepsis (Blood or Urine for culture and sensitivity). Cases with predominant conjugated bilirubin were excluded. The study group included both term and preterm babies with neonatal jaundice. All the data obtained was arranged in a tabulated form and analysed using SPSS software. Results: There were 33.33% of newborn who were delivered by SVD, 55.5% by LSCS and 11.11% by forceps. The neonates were less than 1 day to 8 days old. There were 61.1% males and 38.8% females who had neonatal jaundice. There were 27.7% of ET cases were done between 24-72 HOL, 66.6% done between 3-7 DOL. The pre ET values range in ABO incompatability is 14-20 mg/dl and in RH HDN is 20-28 mg/dl Percentage of reduction in indirect bilirubin after ET in ABO incompatability is ranging from 57-60% and in RH HDN is 50%. Conclusion: Analysis shows that the common etiological factors requiring ET in decreasing order of frequency are ABO incompatibility, prematurity, RH - HDN, and Sepsis. The efficacy of the ET procedure is 50% well comparable to other studies. Only 1 case needed second ET procedure to treat the hyperbilirubinemia. There was no mortality or morbidity attributed to the ET procedure in our hospital.
Authors and Affiliations
Satyasree Devineni
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