Clinical Investigation

Neonatal Exchange Transfusion: Experience of a State Hospital in Ankara During a Four Year Period

  • Ülkü TIRAŞ
  • Resul YILMAZ
  • Yıldız DALLAR

Received Date: 17.01.2008 Accepted Date: 28.05.2008 Meandros Med Dent J 2008;9(2):5-10

Purpose:

We aimed to determine the etiology, complications and treatment outcome of patients who underwent exchange transfusion (ET) for neonatal hyperbilirubinemia in our hospital.

Materials and Methods:

This retrospective study was performed at Ankara State Hospital between January 1998 and December 2001. Among 1152 patients admitted for hyperbilirubinemia 91 exchange transfusions which were performed on 79 (6.86%) neonates were evaluated.

Results:

Mean age at admission was 4.1 2.7 days.ABOincompatibility was detected in 29 (36.7 %) cases andRh incompatibility in 5 (6.3%) cases and one case had bothABO and Rh incompatibility. Hemoglobin (Hb), calcium, bilirubin and platelet count before and after ET showed statistically significant difference(p<0.05). Exchange transfusion complications occurred in 45 neonates (56.9%). These were: anaemia n=30 (37.9%); hypercalcemia n=29 (36.7%); thrombocytopenia n=20 (25.3%) sepsis n=2 (2.5%); cardiopulmonary arrest n=1 (1.2%).

Conclusion:

ET is still the gold standard for treatment of severe neonatal hyperbilirubinemia. In our seriesABO incompatibility was found to be the most common cause of neonatal jaundice. The morbidity caused by ET is high; therefore it should be performed in clinics which were responding to these complications of ET. When the risks of hyperbilirubinemia overweigh ET complications, ET must not be delayed. All pregnancies must be investigated forABOincompatibility during the prenatal period and labour must take place in a medical centre.

Keywords: Neonatal exchange transfusion, thrombocytopenia, hypercalcemia, hyperbilirubinemia