Abstract
In hyperbilirubinemia of ABO hemolytic disease of newborn (ABO-HBN), phototherapy is less effective in lowering bilirubin concentrations than in hyperbilirubinemia of prematurity or nonhemolytic disorders of newborns. Nevertheless, phototherapy does alter patterns of serum bilirubin in ABO-HDN, as seen in a comparison of 29 treated infants with 144 untreated infants.
In ABO-HDN, recognizable patterns of serum bilirubin result from variations in the severity of onset in the 1st day of life, and in the time, extent, and duration of maximum serum bilirubin concentrations. A severe onset is seen in of infants with ABO-HDN, serum bilirubin increasing at a rate of 0.5 mg/hr or greater. Peak bilirubin levels are noted on day 1 (10% of infants), day 2 (30%), day 3 (40%) and day 4 or 5 (20%). The peak bilirubin concentration is less than 16 mg% in of the infants; between 16 and 19 mg% in and exceeds 20 mg% in the remaining . In of infants the maximum bilirubin concentration remains unchanged for at least 24 hrs. before decreasing.
On phototherapy, the bilirubin levels in 20% of infants with ABO-HDN continue to rise, remain unchanged in 40% and decrease in 40%. Light is least effective in infants with severe onset during the 1st day of life. However, in no infant on phototherapy does bilirubin reach its peak after the 3rd day of life and the maximum bilirubin concentration exceeds 20 mg% in only 10% of treated infants.
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Kaplan, E., Herz, F., Scheye, E. et al. Phototherapy in ABO hemolytic disease of newborn. Pediatr Res 5, 407 (1971). https://doi.org/10.1203/00006450-197108000-00150
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DOI: https://doi.org/10.1203/00006450-197108000-00150