HYPERBILIRUBINEMIA

Background: Neonatal jaundice is a common condition in the early days ofinfant’s life. It clinically manifests in a significant number of full term babies and almost allpremature neonates. Increase in the serum bilirubin during early infancy is multi factorial andmay result in kernicterus. Deposition of unconjugated bilirubin in the brain stem nuclei andbasal ganglion results in permanent brain damage. Objective: To determine the frequencyof common hemolytic causes of hyperbilirubinemia in full term neonates requiring exchangetransfusion. Study Design: Cross-sectional study. Setting: Department of Pediatrics, LadyReading Hospital Peshawar. Period: January to June 2015. Methodology: A total of 449 fullterm neonates requiring exchange transfusion were included in this study on the basis of serumbilirubin level (total, direct, indirect). Hemolytic causes were analyzed by checking blood groups,rhesus factors and measuring glucose 6 phosphate dehydrogenase (G6PD) levels. Results: Inthis study mean age was 10 days with standard deviation ± 1.26. Sixty two percent neonateswere male and 38% were female. Hemolytic causes were analyzed and ABO incompatibilitywas found in 25% neonates, rhesus incompatibility in 15% neonates and G6PD deficiency in32% neonates. Conclusion: In this study, the most common cause of severe jaundice requiringexchange transfusion was G6PD deficiency (33%) with hemolysis.