An early (sixth-hour) serum bilirubin measurement is useful in predicting the development of significant hyperbilirubinemia and severe ABO hemolytic disease in a selective high-risk population of newborns with ABO incompatibility
. Pediatrics 2002;109(4):e53.
The culprit antibodies are either naturally occurring (anti A, anti B) or immune mediated antibodies resulting from sensitizations after transfusion or pregnancy.12 There are over 60 RBC antigens that are responsible for an antigen antibody response, but the Rh group with its D antigen and ABO incompatibility
remains the most significant cause of hemolysis in neonates.
Impact of ABO incompatibility
on outcome after allogeneic peripheral blood stem cell transplantation.
In the setting of hemolysis due to ABO incompatibility
, researchers postulate that IVIG may block the maternal antibodies circulating in the baby's bloodstream from destroying the baby's RBCs, halting the progression of hemolytic anemia .
Two studies that looked specifically at the automatic testing approach concluded that there are no appropriate screening tests capable of selecting those ABO incompatible infants who will have hemolytic disease severe enough to require treatment.[4,5] It was concluded that screening for hemolytic disease due to ABO incompatibility
was not cost-effective, and the importance of clinical observation of the newborn was emphasized. However, neither study compared the outcomes of infants tested automatically with those tested selectively.
and haemolytic disease of the newborn.
Table-1: Total Live births and neonates treated for Year Live Births Neonatal Hyperbilirubinemia 2012 2611 364 2013 2978 389 Total 5589 753 Table-2: Factors associated with unconjugated neonatal hyperbilirubinemia Factors Associated Number Percentage Gender Male 403 53.5 Female 350 46.5 Gestational Age Term 506 67.1 Preterm 247 32.9 Birth Weight Low Birth Weight 105 13.9 Very Low Birth Weight 70 9.3 Extremely Low 35 4.6 Birth Weight Parity Primi 490 65.1 Multi 263 34.9 Mode of Caesarean Section 333 44.2% Delivery Normal Vaginal Delivery 420 55.8% Figure-1: Causes of neonatal hyperbilirubinemia Sepsis 87 Cephalohematoma 35 ABO incompatibility
318 Rh Incompatibility 71 Unknown 245 Note: Table made from pie chart.
[Efficacy of intensive blue double-lamp phototherapy in the treatment of ABO incompatibility
and idiopathic severe hemolytic jaundice].
The incidence of ABO incompatibility
was 13.79% and of Rh incompatibility was 1.37%.
In our study, it was observed that ABO incompatibility
in 108 neonates (20.76%) was comparable to Joshi et al 2004.
Causes identified by laboratory investigations include Rh and ABO incompatibility
, as well as glucose-6-phosphate dehydrogenase (G6PD) deficiency.
The prevalence of G6PD deficiency in the present series was (5.71%) ABO incompatibility
was (1.43%) and Rh incompatibility was (5.71%).