The Turkish Journal of Pediatrics
2010 , Vol 52 , Num 2
The Etiology of Severe Neonatal Hyperbilirubinemia and Complications of Exchange Transfusion
Department of Pediatrics, Kahramanmaraş Sütçü İmam University Faculty of Medicine, Kahramanmaraş, Turkey
Exchange transfusion (ECT) has an important role in preventing kernicterus
in the treatment of indirect hyperbilirubinemia of the newborn. In present
study, the etiology of hyperbilirubinemia and complications of ECT were
studied over a five-year period in the Eastern Mediterranean region of Turkey.
We describe our experience of 89 ECTs performed from 2003-2008 in 79
newborns with hyperbilirubinemia. The mean gestational age was 37±2.1
weeks and the mean of peak total bilirubin levels was 28.1±6.4 mg/dl. The
most common cause of hyperbilirubinemia was ABO isoimmunization (38%).
Complications of ECT developed in 17 neonates (21.5%), the most common
being thrombocytopenia and seizure. None of newborns died secondary to
ECT.
Our data showed higher morbidity rates associated with ECT in the treatment of hyperbilirubinemia in our region. In order to prevent adverse effects of ECT, serum bilirubin levels should be closely monitored in newborns with ABO immunization.
Keywords : hyperbilirubinemia, etiology, exchange transfusion, complications, ABO isoimmunization.