CLINICAL CHARACTERISTICS AND MANAGEMENT OF Rh-D HAEMOLYTIC DISEASE OF NEWBORN
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2017, Vol 6, Issue 76
Abstract
BACKGROUND In Rh-D haemolytic disease of foetus and newborn (HDFN), newborns can be severely affected, thereby associated with extensive morbidity and mortality. Aim- The aim of this study is to describe the clinical profile of Rh-D HDFN. Settings and Design- This was a descriptive study conducted in newborn, who had Rh-D HDFN. Setting was Depts. of Transfusion Medicine and Paediatrics in Govt. Medical College, Trivandrum. MATERIALS AND METHODS Enrolment of newborn was done according to inclusion criteria. Maternal and neonatal details were noted and risk of jaundice, severity of disease and intensity of treatment was assessed. Statistical Analysis- All statistical data were analysed using SPSS software version 16. RESULTS 29 (65.9%) belonged to male gender and 15 (34.1%) to female gender. The mean bilirubin levels in neonates on Day 1, 2, 3, 4 and 5 were 4.15, 6.66, 9.44, 11.1 and 11.14 mg% respectively; 20 (45.5%) belonged to low risk, 13 (29.5%) to low intermediate risk, 7 (15.9%) to high intermediate risk and 4 (9.1%) to high risk categories; 4 (9.1%) belonged to no anaemia category, 17 (38.6%) belonged to mild anaemia category, 19 (43.2%) to moderate category and 4 (9.1%) to severe category; 35 (79.5%) of infants showed signs of haemolysis; 33 (75%), 7 (15.9%), 3 (6.8%) and 1 (2.3%) infants had mild, moderate, severe and very severe disease respectively; 20 (45.5%) infants required no treatment; 13 (29.5%) infants were treated only with phototherapy. IVIG was given along with phototherapy in 7 (15.9%) infants; 4 (9.1%) infants were treated with exchange transfusion along with IVIG and phototherapy. Neonates were transfused with 9 (20.5%) packed red blood cells, 3 (6.8%) platelets and 2 (4.5%) fresh frozen plasma. Results of intensity of treatment was 20 (45.5%) belonged to grade 0, 13 (29.5%) to grade 1 category; 7 (15.9%) fell into grade 2, 3 (6.8%) into grade 3 and 1 (2.3%) into grade 4 category of treatment. CONCLUSION Male infants had higher risk of developing Rh-D HDFN. Majority of infants had mild hyperbilirubinaemia and anaemia only. Disease was mild among 3/4th of infants and almost half of the infants required no treatment.
Authors and Affiliations
Sajith Vilambil, Meena Dharmadas, Kumari Krishnakumariamma Chakrapani Usha, Shaiji Panthiyil Shahulhameed, Chitra James, Anjaly Padmavilas Sasikala, Soonam John, Vineeth Rajagopal
Keywords
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- DOI 10.14260/Jemds/2017/1177
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