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Unusual cause of severe neonatal hyperbilirubinaemia: a twin case

Shikha Khandelwal1, Aakash Pandita1, Girish Gupta1

  • 1Department of Neonatology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.

BMJ Case Reports
|March 8, 2019
PubMed

Insights

This case study highlights severe hyperbilirubinaemia in newborn twins due to Rh incompatibility. Prompt interventions, including exchange transfusions and phototherapy, were crucial for their recovery.

Area of Science:

  • Neonatal Medicine
  • Pediatric Hematology
  • Clinical Case Study

Background:

  • Severe hyperbilirubinaemia is a critical condition in newborns.
  • Blood group incompatibility can lead to significant neonatal complications.

Observation:

  • A multigravida mother delivered twins (both O positive) with a B positive blood type.
  • Twin 1 required two exchange transfusions, and Twin 2 received phototherapy and a packed red blood cell transfusion.
  • Both twins presented with severe hyperbilirubinaemia and fluctuating hematocrit levels.

Findings:

  • Investigations revealed a minor blood incompatibility between the mother and twins.
  • Twin 2 underwent a double volume exchange transfusion due to rapidly rising bilirubin levels.
  • Both neonates were treated for sepsis and monitored for serum bilirubin and hematocrit.

Implications:

  • Early identification and management of blood group incompatibility are vital in neonatal care.
  • Exchange transfusions and intensive phototherapy are effective treatments for severe hyperbilirubinaemia.
  • This case underscores the importance of vigilant monitoring in newborns with risk factors for jaundice.

Keywords:
haematology (drugs and medicines)immunological products and vaccinesimmunologyneonatal intensive carepaediatrics (drugs and medicines)

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