الفهرس 
NEONATAL HYPERBILIRUBINEMIA
Transcutaneous bilirubin estimationOnly 14 pages are availabe for public view
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Abstract
Hemolytic disease of the newborn (also called erythroblastosis fetalis) is a condition in which, the fetal red cell cross the placenta and the mother is immunized with these fetal red cell antigen, the resulting immune response triggers the production of IgG antibodies, often in high titres and with high affinity that are then transferred to the fetus and cause hemolysis of fetal red cells.
The conventional treatment measures for neonatal immune hemolytic disease are phototherapy and blood exchange transfusion. Exchange transfusion is however not without risk. Although the mortality rate for exchange transfusion has been reported to be between 0.3-1.2%.
High dose intravenous immunoglobulin therapy has been efficaciously and successfully used in the treatment of neonatal immune hemolytic disease which is less invasive than exchange transfusion and without any adverse reaction.
The present study was aimed to assess the effectiveness of high dose intravenous immuno-globulin in reducing the need for exchange transfusion and duration of phototherapy and hospital stay in neonates with hemolytic disease due to Rh or ABO incompatibilities.
This study was performed on (116) neonates delivered at Gynecology and Obstetric Hospital, Ain Shams University in the period from June 2006 to August 2007.
The study group included 60 neonates, 27 male and 33 female with mean birth weight 2.880.75kg and mean gestational age 37.242.44wks.
The second group included 56 neonates served as control group, 34 male and 22 female with mean birth weight 2.660.65kg and mean gestational age 37.432.51wks.
All neonates were subjected to full history taking, clinical examination and laboratory investigations including blood group (ABO and Rh), complete blood count, reticulocytic count, C-reactive protein and determination of indirect bilirubin.
This study revealed the following results:
• Significant decrease in number of neonates in need of exchange transfusion (single or multiple) in case group [9 out of 60 (15%) and 0 out of 60 (0%) respectively] compared to control group [23 out of 56 (41.01%), and 15 out of 56 (26.8%) respectively].
• Significant decrease in mean length of hospital stay in case group (27.918.67 hours) compared to control group (103.530.74 hours).
• Significant decrease in mean duration of intensive and single phototherapy in case group [9.9666.17 hours and 6.872.14 hours respectively] compared to control group [35.527.26 hours and 21.3210.66 hours respectively].