2018•Unpublished venueRequires access
Common Etiological Spectrum of indirect Hyperbilirubinemia in Neonates
Ihsan Ul Haq, Israr Ul Haq, Sardar Ayub Khan, Zahir Sayed
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Abstract
BACKGROUND: Jaundice is a clinical sign which indicates hemolysis and hyper bilirubinemia and making pathological hyper st bilirubinemia as significant disease burden. Approximately 60% of term and 80% of preterm neonates become jaundiced in 1 week of neonatal life. Among them 5-10% patients need intervention and treatment for hyperbilirubinemia. OBJECTIVE: To determine the common etiological spectrum of indirect hyperbilirubinemia during neonatal life. MATERIAL & METHODS: This is a six months descriptive study that was conducted in neonatal unit, Department of Pediatrics, Saidu group of Teaching Hospital, Swat, from 1 July 2016 to 31 December 2016. Total of 201 Newborns upto 28 days of life who presented with jaundice were included in the study. Biodata and clinical profiles of all these newborns were collected on a predesigned proforma. Special smear with retic count, direct coomb's test, baby and mother blood group, total and fractionated serum bilirubin levels and G6PD level assessment were carried out in all these patients. Extremely premature neonates (gestational . age<32 weeks), and neonatal sepsis were excluded from the study RESULTS: Out of 550 newborns admitted to neonatal unit during the six months' study period (1 July to 31 December 2016), 201(36.54%) patients had jaundice with male 120(59.71%) and female 81(40.29%). Among these 201 jaundiced patients ABO incompatibility was found in 64 (31.84%) patients,57(28.35%) patients found to be G6PD deficient, Rh incompatibility in 27(13.45%) and in 53(26.36%) patients no definite cause have been found. All jaundiced patient received phototherapy, exchange blood transfusion was done in 37patients (18.40%), double exchange transfusion was done in 3 patients (1.49%) and 4(1.99%) patients developed Kernicterus. CONCLUSION: ABO incompatibility, G6PD deficiency and Rh incompatibility are the common causes of unconjugated hyperbilirubinemia. A delay in management or seeking medical advice can lead to Kernicterus