Publicação
Clinical case report: severe neonatal jaundice due to ABO incompatibility
| Resumo: | A male newborn, delivered at 38 weeks via cesarean section due to fetal distress, weighed 2.9 kg at birth. He had low APGAR scores-4 at the 1st minute and 6 at the 5th-indicating clinical instability. He was admitted to the neonatal unit with severe jaundice, respiratory distress, and hemodynamic instability. Initial labs revealed anemia (hemoglobin 7 g/dL) and elevated indirect bilirubin. A positive direct Coombs test confirmed hemolytic anemia due to ABO incompatibility, which exacerbated the jaundice.Despite initiation of intensive phototherapy, bilirubin levels remained critically high, raising concern for bilirubin encephalopathy. Given the lack of response and risk of neurological damage, an exchange transfusion was promptly indicated. This therapeutic procedure involves replacing the infant's blood with donor blood to reduce bilirubin levels and remove maternal antibodies. The newborn was placed in a supine position, and the transfusion was performed in stages, replacing approximately 85% of his blood volume with double the volume of fresh donor blood. The procedure was carried out under continuous monitoring of vital signs, laboratory parameters, and strict hemodynamic control. |
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| Autores principais: | Pimentel, Maria Helena |
| Outros Autores: | Antão, Celeste |
| Assunto: | Hemolytic anemia ABO incompatibility Exchange tansfusion |
| Ano: | 2025 |
| País: | Portugal |
| Tipo de documento: | documento de conferência |
| Tipo de acesso: | acesso aberto |
| Instituição associada: | Instituto Politécnico de Bragança |
| Idioma: | inglês |
| Origem: | Biblioteca Digital do IPB |
| Resumo: | A male newborn, delivered at 38 weeks via cesarean section due to fetal distress, weighed 2.9 kg at birth. He had low APGAR scores-4 at the 1st minute and 6 at the 5th-indicating clinical instability. He was admitted to the neonatal unit with severe jaundice, respiratory distress, and hemodynamic instability. Initial labs revealed anemia (hemoglobin 7 g/dL) and elevated indirect bilirubin. A positive direct Coombs test confirmed hemolytic anemia due to ABO incompatibility, which exacerbated the jaundice.Despite initiation of intensive phototherapy, bilirubin levels remained critically high, raising concern for bilirubin encephalopathy. Given the lack of response and risk of neurological damage, an exchange transfusion was promptly indicated. This therapeutic procedure involves replacing the infant's blood with donor blood to reduce bilirubin levels and remove maternal antibodies. The newborn was placed in a supine position, and the transfusion was performed in stages, replacing approximately 85% of his blood volume with double the volume of fresh donor blood. The procedure was carried out under continuous monitoring of vital signs, laboratory parameters, and strict hemodynamic control. |
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