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AIM OF THE WORK

1. Detect the incidence of ABO incompatibility in neonatal jaundice.

2. Compare between O-A & O-B blood subgroups incompatibles
in incidence and severity and need for exchange transfusion.

3. Identify factors affecting presence of ABO incompatibility
neonatal jaundice.

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Patients and Methods
The patients for this study will be collected from full term healthy newborns admitted to neonatal intensive care unit at MENOUF hospital among the period of six month including about 106 babies of different gender [males and females].

Inclusion criteria:
1. Newborns with gestation ages ranged from (37weeks42weeks).

2. Newborns whose weights greater than 2500 3. Infant of blood group A OR B born to mother of blood group O. 4. Jaundice observed clinically within 1st 48 hours of birth [serum
indirect bilirubin levels as follow : > 5mg/dl at 12 hs, >8mg/dl at 24 hs, >12.5 mg/dl at 48 hs]

5. Patients who need exchange transfusion [serum indirect
bilirubin concentration increasing by 0.5-1 mg/dl/h or exceeding 20 mg/dl].

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Exclusion criteria:
1. Newborns < 37weaks. 2. Newborns<2.5 KG.

3. Newborns with Rh incompatibility. 4. Sick newborns like:
• Newborns with respiratory distress. • Newborns with perinatal asphyxia. • Newborns with congenital anomalies. • Newborns with neonatal sepsis. • Newborns with history or manifestations of congenital infection 5. Babies whose mothers were hepatitis A IgM positive, HBsAg (hepatitis B surface antigen) positive, and anti – HCV (hepatitis C antibody) positive .

All patients will be submitted to:
1- Full history was taken from both mother and obstetricians post
natal to detect the presence or absence of maternal risk factors for neonatal hyperbilirubinemia as pregnancy induced hypertension, diabetes mellitus. Previous jaundiced baby obstructed labour, oxytocin using, C.S, passive smoking, Rh – ve and prolonged premature rupture of membrane. 2- Full clinical examination of newborn done to detect the presence or absence of neonatal risk factors for hyperbilirubinemia as cephalohematoma, feeding pattern, weight, gestational age, and gender.

3- The following laboratory investigations will be done:  Blood group of the mothers and their babies.
 Total serum bilirubin (TsB).  Indirect bilirubin level.

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The 2nd 3rd tests will be done to patients in 1st, 2nd and 4th days.

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Statistical method
Using Microsoft Excel 2003 and SPSS v18.0 for Microsoft Windows 7 the clinical and laboratory data were statistically analyzed. Categorical variables were analyzed by chi-square or student t-tests.

Hypothesis
In our study, we conjectured that higher severity of ABO incompatibility HDN may occur with O-B infant than O-A infants.

 The null hypothesis: There is no difference is tested.  The alternative hypothesis: There is a difference between O-A
and O_B severity of the disease. But the data give rise to rejection of the null hypothesis and accept of the alternative hypothesis falsely suggesting that there is higher severity of ABO incompatibility HDN in O-B infant than O-A infants. NB: 1- P value less than 0.05 (P < 0.05) was considered significant. 2- P Value less than 0.01 (p < 0.01) was considered highly significant. 3- P value more than 0.05 (p > 0.05) was considered insignificant (Bland, 2000 and Kirkwood, 2003 )

Obstacles and constrains
Some of data may appear incomplete due to defective registrations in some of the files.

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