| The Clinical Study of Neonatal Hyperbilirubinemia Requiring Exchange Transfusion |
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J.H. Kim, Y.I. Yoon, H.S. Lee |
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Dept, of Ped., Ewha Womans University, School of Medicine |
| 新生兒 黃造에 對한 交換輸血의 臨床的 考察 |
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金丁鎬, 尹龍任, 李漢淑 |
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梨花女子大學校 醫科大學 小兒科學敎室 |
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| Abstract |
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This paper is a brief review of 6, 658 Korean newborn babies admitted into the Pediatric unit including newborn nursery and prematurity room, Ewha Womans University Hospital, with the period of Sept. 1964 to Dec. 1967. Out of 6, 658 newborn babies, 3,876 babies developed jaundice giving an incidence of 5.9% Of the 3,876 jaundiced babies, 30 required exchange trasfusion. As regards the cause of neonatal jaundice, it must be mentioned that not all jaundiced babies were completely worked up as some of them had only transient jaundice. The etiological factors of neonatal jaundice are briefly analysed in table 2. Only cases with total serum bilirubin above 15 mg/100 ml were completely investigated, and hyperbili-rubinemia with above 20~22 mg/100 ml were subjected for exchange transfusion. Of the known causes, ABO incompatibility occured far more than the others and there were 8 cases of sepsis, 2 cases of congenital syphilis, 9 cases of unknown origin, but none of Rh-incompatibility. Majority of hyperbilirubinemia babies developed jaundice on 2nd and 3rd day and pick bilirubin level was usually obtained between the 3rd to 5 th day. Hemolytic jaundice due to Rhesus incompatibility is a extremely rare among Koreans since the over whelming majority are Rhesus positive, where as ABO incompatibility seems to be a common causes of hemolytic jaundice in the first week of life. We considered that hemolytic jaunice occuring within newborn period in which the mother was group O and baby was either group A or B as being caused ABO incompatibility. We presums that severe hemolytic jaundice with ABO incompatibility constituted major group of patients requiring exchange transfusion, and resulted in Kernictems or death. Sepsis and Syphilis were also thought to be important factors of significance in the cause of neonatal jaundice. Of the 30 exchange transfused babies, 20 were premature babies developed jaundice, early and main-tained high bilirubin level for long period compare with term babies. The jaundiced babies who recieved exchange transfusion were found to have, in general, a moderate anemia. One baby who was brought to the hospital with severe jaundice, developed convulsion, refusaling milk, high pitched crying (Cerebral cry).
Of the 30 jaundiced babies who required exchange trasfusion, 3 had kemicterus on admission, of which two died in the hospital and one baby discharged with sequelle. |
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