[Multiple IV iimmunoglobulin therapy in newborns with immune hemolytic jaundice]

ABSTRACT

The Conventional treatment for neonatal immune hemolytic disease is, phototherapy and blood exchange transfusion. The aim of this study was to determine the efficasy of multiple dose of IVIG in reducing the need for exchange transfusion and phototherapy in hemolytic jaundice of newborn. The study was performed at NICU of Ghaem Hospital as a case - control study, over a period of one year [oct 2002-oct 2003]. Patients with ABO and RH incompatibility, proven by significant hyperbilirubinemia [Bill>8mg/dl at 12hr of age], positive direct or indirect comb's, and no other Risk factors, like sepsis and G6PD deficiency or early familial icterus, were randomly assigned to receive either conventional intensive phototherapy alone or phototherapy with IVIG 0.5gr/kg every 12hr for three times. Exchange transfusion was performed if billirubin exceded more than 20mg/dl. A total of 34 newborn infants were included in the study. There was no significant difference between two groups, with respect to birth weight, postnatal age, sex, bilirubin, hematocrit, or reticulocite count. The number of exchange transfusion, duration of phototheray and hospitalization, were significantly lower in IVIg treatment group than control one. Adverse effects were not observed during IVIG treatment. IVIG therapy is a safe treatment for newborns with hemolytic jaundice and Reduces exchange transfusion