Prediction of the development of hyperbilirubinemia in ABO incompatibility.

In our present setting ABO incompatibility is now the most common cause of isoimmune hemolytic disease of the newborn. Although known to be clinically milder than Rh incompatibility, severe hemolysis occurs and some cases require exchange transfusion. This study aims to assess the predictive value of cord blood bilirubin and direct Coombs test in the development of neonatal hyperbilirubinimia in ABO incompatibility. Fifty-three healthy full term infants were included from June to December 1994 St. Lukes Nursery Unit, weighing 2.5-3.0 kg, born to 0 + primigravid and secundy mothers with unremarkable maternal history. Cord blood bilirubin levels, direct Coombs test and babys blood type were determined. A second bilirubin level was taken once jaundice occured and phototherapy initiated at bilirubin levels of 13 mg/dl ABO incompatible newborn infants born to a primigravid or secundy, cord blood bilirubin level of 2.0mg/dl or positive Coombs test of the cord blood should be labelled as high risk category. Neonatal jaundice maybe an early clue to a lethal disease, thus frequent re-evaluation, good clinical judgment and initiation of prompt and appropriate therapy should always be made available.