Dr. Muhammad Usman Ali, Dr. Munazah Arif , Dr Faisal Khurshid
Hyperbilirubinemia develops to some extent as a normal transition in physiology in almost all newborns. High levels of bilirubin can cross the blood-brain barrier in unbound unconjugated form and cause neurological symptoms. Objectives: To determine the frequency of exchange transfusion in neonates with hyperbilirubinemia and to describe the characteristics of neonates with hyperbilirubinemia, including those who underwent exchange transfusion. Place and Duration: In the Pediatric department of Benazir Bhutto Hospital Rawalpindi for one-year duration from March 2019 to February 2020. Methods: A retrospective study was conducted to investigate the frequency of exchange transfusion in newborns admitted to hospital with hyperbilirubinemia and to investigate selected characteristics of these infants, including: gender, gestational age, body weight, type of feeding and delivery, and to identify the causes of hyperbilirubinemia. Results: A total of 120 newborns, 70 men and 50 women were enrolled in the study. Most of them (67%) were of legal age, weighing over 2.5 kg. The majority (77%) were administered vaginally, and the main source of feeding was mixed breastfeeding and formula milk. The mean value of serum bilirubin at admission was 14.7 mg / dL, and 22 mg / dL at the time of replacement for patients undergoing exchange transfusion. In 92 children (77%), the cause of the hyperbilirubinemia was unknown. Hemolytic anemia due to Rh-ABO incompatibility was found in 16% of children, and G6PD deficiency in 7%. Exchange transfusion was performed in 16.6% of patients. Conclusion: Although neonatal jaundice is mostly a benign condition, pathological harmful hyperbilirubinemia can occur and despite the benefits of phototherapy, exchange transfusion is still performed and kernicterus is still present. It carries many risks for newborns and prevents kernicterus Keywords: Neonatal jaundice, transfusion change, Kernicterus.