Abstract
References
- 1. Yaseen H, Khalaf M, Rashid N, Darwich M. Does prophylactic phototherapy prevent hyperbilirubinemia in neonates with AB0 incompatibility and positive Coombs’ test? J Perinatol 2005;25:590-4.
- 2. Sarici SU, Yurdakök M, Serdar MA, Oran O, Erdem G, Tekinalp G, et al. An early (sixth-hour) serum bilirubin measurement is useful in predicting the development of significant hyperbilirubinemia and severe AB0 hemolytic disease in a selective high-risk population of newborns with AB0 incompatibility. Pediatrics 2002;109:e53.
- 3. Sgro M, Campbell D, Shah V. Incidence and causes of severe neonatal hyperbilirubinemia in Canada. CMAJ 2006;12:587-90.
- 4. American Academy of Pediatrics Subcommittee on Hyperbilirubinemia. Management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. Pediatrics 2004;114:297-316.
- 5. Clifford JH, Mathews P, Reiquam CW, Palmer HD. Screening for hemolytic disease of the newborn by cord blood Coomb testing: Analysis of a five-year experience. Clin Pediatrics 1968;7:465-9.
- 6. Alter AA, Feldman F, Twersky J, De Vos E, Prutting DL, Miotti A, et al. Direct antiglobulin test in AB0 hemolytic disease of the newborn. Obstet Gynec 1969;33:846-51.
AB0 Uygunsuzluğuna Bağlı Hiperbilirubinemili Yenidoğanlarda Fototerapi Gereksinimi Öngörülebilir mi?
Abstract
Amaç: Çalışmada, AB0 uygunsuzluğuna bağlı indirekt hiperbilirubinemi (İHB) gelişen yenidoğanlarda, fototerapi gereksinimini ilk gün saptayabilecek belirteçler araştırıldı.
Gereç ve Yöntemler: Anne-bebek arasında AB0 uygunsuzluğu olan, zamanında doğmuş, ek hastalığı olmayan sağlıklı yenidoğanlar ileriye dönük izlem amacıyla çalışmaya alındı. Olguların ilk 6. ve 24. saatlerinde hemoglobin (Hgb), bilirubin ve laktat dehidrogenaz (LDH) düzeylerine bakıldı. Olguların ilk 15 gün Bhutani nomogramına uygun sıklıkta serum bilirubin düzeyleri takip edildi ve fototerapi gereksinimi Amerikan Pediatri Akademisi’nin önerdiği sınırlar kullanılarak belirlendi. Fototerapi sınırını geçerek fototerapi uygulanan bebeklerle, fototerapi sınırının altında kalanların sonuçları karşılaştırıldı.
Bulgular: AB0 uygunsuzluğu nedeniyle çalışmaya alınan 83 bebekten 18’inde B0 (%21.7), 65’inde (%78.3) A0 uygunsuzluğu saptandı. Bebeklerin 44’ünde (%53) direkt antiglobulin testi (DAT) pozitifti. DAT pozitif olan yenidoğanların 13’ü (%33.3), DAT negatif olanların ise 12’si (%27.3) izlemde İHB nedeniyle fototerapi aldı. İki grup arasında yatış sıklığı açısından anlamlı fark yoktu (p=0.58).
İndirekt hiperbilirubinemi nedeniyle fototerapi uygulanan ve uygulanmayan gruplar arasında 6. ve 24. saat Hgb ile LDH düzeyleri arasında anlamlı fark saptanmadı (p>0.05). Ancak, fototerapi gereksinimi olan hiperbilirubinemili bebeklerde 24. saat bilirubin düzeyleri, fototerapi ihtiyacı olmayanlara göre daha yüksek bulundu (p=0.03).
Sonuç: Yenidoğanlarda AB0 uygunsuzluğuna bağlı İHB nedeniyle fototerapi gereksiniminin belirlenmesinde, 24. saat Hgb, DAT ve LDH düzeylerinin prediktif değeri yoktur, ancak 24. saat bilirubin düzeyi prediktif olabilir. AB0 uygunsuzluğuna bağlı hemolitik hastalık spektrumunun geniş olması nedeniyle, AB0 uygunsuzluğu olan yenidoğanların yakın izlenmeleri gerektiği düşünülmüştür.
References
- 1. Yaseen H, Khalaf M, Rashid N, Darwich M. Does prophylactic phototherapy prevent hyperbilirubinemia in neonates with AB0 incompatibility and positive Coombs’ test? J Perinatol 2005;25:590-4.
- 2. Sarici SU, Yurdakök M, Serdar MA, Oran O, Erdem G, Tekinalp G, et al. An early (sixth-hour) serum bilirubin measurement is useful in predicting the development of significant hyperbilirubinemia and severe AB0 hemolytic disease in a selective high-risk population of newborns with AB0 incompatibility. Pediatrics 2002;109:e53.
- 3. Sgro M, Campbell D, Shah V. Incidence and causes of severe neonatal hyperbilirubinemia in Canada. CMAJ 2006;12:587-90.
- 4. American Academy of Pediatrics Subcommittee on Hyperbilirubinemia. Management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. Pediatrics 2004;114:297-316.
- 5. Clifford JH, Mathews P, Reiquam CW, Palmer HD. Screening for hemolytic disease of the newborn by cord blood Coomb testing: Analysis of a five-year experience. Clin Pediatrics 1968;7:465-9.
- 6. Alter AA, Feldman F, Twersky J, De Vos E, Prutting DL, Miotti A, et al. Direct antiglobulin test in AB0 hemolytic disease of the newborn. Obstet Gynec 1969;33:846-51.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Internal Diseases |
| Journal Section | ORIGINAL ARTICLES |
| Authors | |
| Publication Date | September 23, 2019 |
| Submission Date | June 13, 2018 |
| Published in Issue | Year 2019 Volume: 13 Issue: 5 |
Cited By
Prognostic evaluation of newborns with neonatal hyperbilirubinemia
Journal of Medicine and Palliative Care
https://doi.org/10.47582/jompac.1398442
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