Isoimmunization ABO in newborns in Pinar del Río
Keywords:
JAUNDICE, NEWBORN INFANT/inmunology, INMUNIZATION.Abstract
Introduction: early jaundice due to isoimmunization ABO is cause of frequent hospitalization in Neonatology service.
Objective: to characterize newborns with ABO isoimmunization in Pinar del Río province.
Method: an observational, descriptive and cross-sectional study was carried out in the Neonatology service at Abel Santamaría Cuadrado General Teaching Hospital in Pinar del Río during 2015. Target group: 98 newborns older than or equal to 34 weeks of gestational age admitted to Neonatal Intensive Care Unit diagnosed as maternal-fetal isoimmunization. Sample: infants with early jaundice by ABO isoimmunization (n = 67). Infants with early jaundice and associated morbidity were excluded, as well as those with concomitant of the two conflicts (RH and ABO).
Results: the incidence of ABO isoimmunization with respect to total births was 1.08% and related to maternal fetal blood conflicts was 56.1%. In 67.2% gestational age was greater than or equal to 37 weeks, with 74.5% being in primigravidae, more frequent in males (52.7%). Jaundice was the main form of presentation (50.9%), and appeared between 12 and 24 hours of life in 65.4%. The predominant incompatibility was O-A (52.7%), 98.1% presented Coombs direct negative test, severe hyperbilirubinemia developed 77.7%. Intacglobin was used in 30.0% and exchange transfusion in 7.2%.
Conclusion: ABO isoimmunization is a frequent cause of severe hyperbilirubinemia between the second and seventh days of life, indirect bilirubin determined between 24 and 36 hours of life allowing the identification of newborns with the possibility of developing severe hyperbilirubinemia of the newborn.
Downloads
References
1. 1- Fasano RM. Hemolytic disease of the fetus and newborn in the molecular era. Semin Fetal Neonatal Med 2016 [citado 2017 Abr 7]; 21(1): [aprox 6p.]. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/26589360
2- Hisham AE, Azza AG, Tantaw RA, Farrash E, Eman I, et al. CD144+ endothelial microparticles as a marker of endothelial injury in neonatal ABO blood group incompatibility. Blood Transfus [Internet]. 2014 Apr [citado 2017 Abr 7]; 12(2): [aprox 9p.]. Disponible en: http://www.bloodtransfusion.it/articolo.aspx?idart=002689&idriv=92
3-Arenas Rueda YA, Pradilla Arenas GL. Inmunoglobulina endovenosa como una opción en el manejo de la ictericia neonatal por incompatibilidad ABO. MÉD UIS [Internet]. 2015 [citado 2017 Abr 7]; 28(1): [aprox 6 p.]. Disponible en: http://medicasuis.org/anteriores/volumen28.1/art8.pdf
4- Lambertino JR, Villegas SA. Aloinmunización Rh en mujeres gestantes, una mirada al diagnóstico y a su aproximación terapéutica. Ginecol Obstet Mex [Internet]. 2014 [citado 2017 Abr 7]; 82: [aprox 10p.]. Disponible en:
http://www.medigraphic.com/pdfs/ginobsmex/gom-2014/gom1411e.pdf.
5- Ferrer Montoya R, Laurenzo González BC, Ávila Sánchez EA. III Enfermedad hemolítica del recién nacido por isoinmunización a grupos sanguíneos menores. Un caso poco frecuente. Multimed [Internet]. 2016 [citado 2017 Abr 7]; 20(3): Disponible en:
http://www.revmultimed.sld.cu/index.php/mtm/article/view/205/250.
6- Weinstock C, Möhle R, Dorn C, Weisel K, Höchsmann B et al. Successful use of eculizumab for treatment of an acute hemolytic reaction after ABO-incompatible red blood cell transfusion. Transfusion 2015; [citado 2017 Abr 7]; 55(3): [aprox 5 p.]. Disponible en: http://onlinelibrary.wiley.com/doi/10.1111/trf.12882/full.
7- Wusthoff CJ, Loe IM. Impact of bilirubin-induced neurologic dysfunction on neurodevelopmental outcomes. Semin Fetal Neonatal Med 2015; [citado 2017 Abr 7]; 20(1): [aprox 5p.]. Disponible en:
http://www.sciencedirect.com/science/article/pii/S1744165X14000985.
8- Ryan M, Adams MC. Delayed cord clamping in red blood cell alloimmunization: safe, effective, and free?. Transl Pediatr [Internet]. 2016 Apr [citado 2017 Abr 7]; 5(2): [aprox 3 p.]. Disponible en:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4855192/.
9- Peymaneh AT, Mandana S, Negar S. Severe neonatal hyperbilirubinemia leading to exchange transfusión. Med J Islam Repub Iran [Internet].2014 [citado 2017 Abr 7]; 28: 64. Disponible en:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4219894/.
10- Valdes R, Ruiz Y. Normas de Neonatología. En: Neonatología. Diagnóstico y tratamiento. La Habana: Ediciones Médicas, 2012. p. 296.
11-Abdulaziz A, EssamNour Eldin Mohamed NE, Amal Z, Shakil M. Evaluation of neonatal jaundice in the Makkah region. Sci Rep [Internet]. 2014 [citado 2017 Abr 7]; 4:4802. Disponible en: http://www.nature.com/articles/srep04802.
12- Beken S, Hirfanoglu I, Turkyilmaz C, Altuntas N, Unal S, Turan O, et al. Intravenous Immunoglobulin G Treatment in ABO HemolyticDisease of theNewborn, isitMythor Real?.Indian J HematolBloodTransfus 2014 Jan-Mar[citado 2017 Abr 7];; 30(1): [aprox 3p.]. Disponible en: http://link.springer.com/article/10.1007/s12288-012-0186-3.
13- Sulaimon Akanmu A, Abiola Oyedeji O, Adenike Adeyemo T, Abiola Ogbenna A. Estimating the Risk of ABO Hemolytic Disease of theNewborn in Lagos. J Blood Transfusion [Internet]. 2015 [citado 2017 Abr 7]; ID 560738. Disponible en: http://dx.doi.org/10.1155/2015/560738.
14-Cajamarca Berrezueta CA, Rojas Quito SM. Frecuencia de hiperbilirrubinemia por incompatibilidad ABO en recién nacidos [Internet]. Cuenca-Ecuador: Hospital Vicente Corral; 2014 [citado 2017 Abr 7]; Disponible en:
http://dspace.ucuenca.edu.ec/bitstream/123456789/26913/1/PROYECTO%20DE%20INVESTIGACI%C3%93N.pdf
15-Covas MC, Medina MS, Ventura S, Gamero D, Giuliano A, Esandi ME. Enfermedad hemolítica por incompatibilidad ABO y desarrollo de ictericia grave en recién nacidos de término: factores predictivos precoces. Arch Argent Pediatr [Internet]. 2009 Ene-Feb [citado 2017 Abr 7]; 107(1): [aprox 9 p.]. Disponible en:http://www.scielo.org.ar/scielo.php?pid=s0325-00752009000100005&script=sci_arttext&tlng=en.
Published
How to Cite
Issue
Section
License
Authors who have publications with this journal agree to the following terms: Authors will retain their copyrights and grant the journal the right of first publication of their work, which will be publication of their work, which will be simultaneously subject to the Creative Commons Attribution License (CC-BY-NC 4.0) that allows third parties to share the work as long as its author and first publication in this journal are indicated.
Authors may adopt other non-exclusive license agreements for distribution of the published version of the work (e.g.: deposit it in an institutional telematic archive or publish it in a volume). Likewise, and according to the recommendations of the Medical Sciences Editorial (ECIMED), authors must declare in each article their contribution according to the CRediT taxonomy (contributor roles). This taxonomy includes 14 roles, which can be used to represent the tasks typically performed by contributors in scientific academic production. It should be consulted in monograph) whenever initial publication in this journal is indicated. Authors are allowed and encouraged to disseminate their work through the Internet (e.g., in institutional telematic archives or on their web page) before and during the submission process, which may produce interesting exchanges and increase citations of the published work. (See The effect of open access). https://casrai.org/credit/
