RESUMO
Background: Neonatal hyperbilirubinemia continues to be the most common cause of hospital admissions and readmissions in the neonatal population worldwide and this pattern continues despite attempts to identify neonates at risk of pathological hyperbilirubinemia. The aim of the study was to determine the clinical profile and etiology in neonates who were treated with double volume exchange transfusion (DVET).Methods: This was a hospital based prospective observational study in neonates ?35 weeks of gestation who were treated with DVET for severe hyperbilirubinemia in a tertiary care centre over a period of six months.Results: In our study 110 neonates with severe hyperbilirubinemia were treated with DVET. Majority of the neonates were males (59.1%). Lower segment caesarean section (LSCS) was the common mode of delivery observed in 66.4% of the study subjects. Rh incompatibility (36.4%) was the commonest cause of exchange transfusion followed by ABO incompatibility (20%). The mean age of neonates at admission and mean age at DVET in days were 4.03�46 and 4.25�44 respectively. The mean birth weight of neonates treated with DVET was found to be 2.81�57. The mean total serum bilirubin at pre-exchange and post exchange were 26.13�58 mg/dl and 11.63�24 mg/dl respectively.Conclusions: Rh incompatibility was the most common cause in neonates with severe hyperbilirubinemia requiring double volume exchange transfusion.
RESUMO
Background: Neonatal jaundice is the most common problem in the first week of life leading to delayed hospital discharges and readmissions. Recognizing early neonatal hyperbilirubinemia plays a pivotal role in preventing serious complications. The aim of this study was to study the clinical profile and etiological factors leading to neonatal jaundice.Methods: This prospective observational study was conducted in the neonatal intensive care unit (NICU), department of pediatrics, government medical college, Srinagar, Jammu and Kashmir, India over a period of 6 months (August 2023 to January 2024). A total of 400 cases were enrolled for the study. Data collection was done by history taking, clinical examination and relevant laboratory investigations.Results: In this study, out of 400 jaundiced neonates, 236 (59%) were males and 164 (41%) were females, 342 (85.5%) were born at term and remaining 58 (14.5%) were preterm babies. Among 400 neonates studied, majority (80%) had birth weight ?2500 gm. Only 80 (20%) had birth weight less than 2500 gm. Physiological jaundice was seen in 162 (40.5%) of the total cases. This was followed by ABO incompatibility (20%), Rh incompatibility (16.5%), sepsis (8%), idiopathic (5%), prematurity (4%), cephalhematoma (4%) and breastfeeding jaundice (2%).Conclusions: This study concludes that physiological jaundice is the most common cause of neonatal jaundice in our hospital. This was followed by ABO incompatibility, Rh incompatibility and sepsis. This highlights the importance of appropriate monitoring of neonates with these underlying risk factors.