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Abstract
THE RATE 0F EXCHANGE TRANSFUSION PRE AND POST USE OF INTENSIVE PHOTOTHERAPY
Dr. Firas Salam Fakhri*, Dr. Teba Kasim Mohamed and Ali Hussein AL-Faydawi
ABSTRACT
Introduction: Hyperbilirubinemia is a prevalent and generally harmless condition in newborns. Around 60% of full-term infants and 80% of preterm infants experience jaundice in their first week of life. However, hyperbilirubinemia can cause encephalopathy at any point during the neonatal period, with lethargy, poor feeding, and loss of the Moro reflex being common early signs. Objectives: This study aims to evaluate the efficacy of intensive phototherapy in reducing the need for exchange transfusion at AL-Zahraa Teaching Hospital in AL-Najaf city. Method: This retrospective study analyzed 6528 full-term infants with indirect hyperbilirubinemia at Al-Zahraa Teaching Hospital between 2008 and 2011. Exclusions comprised premature newborns, direct hyperbilirubinemia cases, critically ill newborns, and others. The research compared the need for ECT between two periods: 2008-2009 (no IPT) and 2010-2011 (IPT as an alternative). The American Academy of Pediatrics (AAP) guidelines were followed for managing hyperbilirubinemia in the neonatal care unit. Results: The study of 6528 neonates with neonatal jaundice revealed a significant decrease in exchange transfusion (ECT) rates from 668 cases (2008-2009) to 75 cases (2010-2011) following the implementation of intensive phototherapy (IPT), resulting in a 90% reduction. Males were more affected than females. The main cause of hyperbilirubinemia necessitating ECT was ABO incompatibility, followed by Rh incompatibility and other causes, with similar patterns observed in both study periods. Conclusion: In conclusion, extensive phototherapy is more effective in reducing excessive bilirubin levels in all types of newborn jaundice, particularly in cases of Rh and ABO incompatibility. Consequently, highly intensive phototherapy for neonatal jaundice lowered the exchange transfusion rate and associated complications.
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