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- Title
Evaluation of Rh-Hemolytic Disease in Neonates and Management with Early Intensive Phototherapy in the Neonatal Intensive Care Unit.
- Authors
Tewari, Vishal Vishnu; Kumar, Ashutosh; Singhal, Amit; Pillai, Nayana; Prakash, Arya; Varghese, Jaya; Kannan, Venkatnarayan
- Abstract
<bold>Background Of the Study: </bold>In neonates with Rh-hemolytic disease, light emitting diode (LED) phototherapy allows delivery of high spectral irradiance (SI). A linear correlation exists between SI and efficacy of phototherapy with no saturation point. There is scant data on evaluation and early phototherapy using LED units in Rh-hemolytic disease.<bold>Objective: </bold>This study aimed to describe the hemoglobin (Hb), hematocrit (Hct), total serum bilirubin (TSB), phototherapy parameters and short-term outcomes in neonates with Rh-hemolytic disease.<bold>Methodology: </bold>Maternal parameters for Rh-isoimmunization were recorded and monitoring of fetal anemia by Doppler ultrasound was done. Early intensive phototherapy within 1 h of birth was initiated for cord blood Hb below 13.6 g/dl and/or TSB greater than 2.8 mg/dl.<bold>Results: </bold>Fifty Rh positive neonates were enrolled of which 11/50 (22%) received intrauterine transfusions. The maximum TSB remained below 18 mg/dl in 42/50 (84%) of neonates. The mean SI on the trunk was 56.260 ± 8.768 µW/cm2/nm and duration of phototherapy was 7 ± 3.29 days (mean ± SD). There was a positive correlation between strength of indirect antiglobulin test and cord blood Hb: correlation coefficient (r) = 0.295; direct antiglobulin test and duration of phototherapy: r = 0.331. Early packed red blood cell (PRBC) transfusion was required in 8/50 (16%) neonates while 20/50 (40%) required late transfusions.<bold>Conclusion: </bold>With a mean SI of 56.260 ± 8.768 µW/cm2/nm on the trunk, TSB remained below 18 mg/dl in majority thereby avoiding exchange transfusion. Early or late PRBC transfusion requirement was 1 (1-2) (median ± interquartile range).
- Subjects
INTENSIVE care units; NEONATAL intensive care; FETAL monitoring; PHOTOTHERAPY; LIGHT emitting diodes; SPECTRAL irradiance; HEMATOCRIT; HEMOGLOBINS; NEONATAL jaundice; RH isoimmunization; NEONATAL intensive care units; ERYTHROBLASTOSIS fetalis; CORD blood; DOPPLER ultrasonography; BILIRUBIN
- Publication
Journal of Tropical Pediatrics, 2020, Vol 66, Issue 1, p75
- ISSN
0142-6338
- Publication type
journal article
- DOI
10.1093/tropej/fmz033