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Bilirubin encephalopathy in a term infant after planned home delivery
1University of Missouri-Columbia, Department of Child Health 65212.
Insights
A newborn developed severe jaundice and fever due to hemolytic anemia from maternal-fetal blood group incompatibility (anti-c antibody). Despite survival, the infant experienced kernicterus, highlighting risks of unmonitored pregnancies.
Area of Science:
- Neonatal Medicine
- Immunology
- Pediatrics
Background:
- Home birth without prenatal care poses risks.
- Maternal-fetal blood group incompatibility can cause severe neonatal complications.
Observation:
- A term infant presented with fever, poor feeding, and severe jaundice on day three of life.
- The infant's serum indirect bilirubin level was critically high at 49 mg/dl.
Findings:
- The severe jaundice was attributed to isoimmune hemolytic anemia.
- The anemia was caused by maternal anti-c antibodies crossing the placenta.
Implications:
- This case underscores the critical importance of prenatal care and monitoring.
- Untreated hemolytic disease of the newborn can lead to severe neurological sequelae like kernicterus.
- Prompt diagnosis and management of hyperbilirubinemia are vital for preventing long-term infant morbidity.
Abstract:
A term infant was delivered at home by his father after a pregnancy which involved no organized medical care. By the third day of life the infant developed fever, poor feeding and severe jaundice. The infant was found to have a serum indirect bilirubin of 49 mg/dl secondary to isoimmune hemolytic anemia due to anti-c antibody. The infant survived but suffers from clinical manifestations of kernicterus.