Evaluation of Neonatal Hemolytic Jaundice: Clinical and Laboratory Parameters.
BACKGROUND
Neonatal jaundice that occurs in ABO or Rhesus issoimunisation has been recognized as one of the major risk factors for development of severe hyperbilirubinemia and bilirubin neurotoxicity.


OBJECTIVE
Aim of our study was to investigate clinical and laboratory parameters associated with hemolytic jaundice due to Rh and ABO incompatibility and compare results with the group of unspecific jaundice.


METHODS
One hundred sixty seven (167) neonatal hyperbilirubinemia cases were included in the study, 24.6% of which presented with ABO/Rhesus type hemolytic jaundice, and the rest with unspecific jaundice. Evaluation included: blood count, reticulocites, serum bilirubin, aminotransferases, blood grouping, and Coombs test, also the day of bilirubin peak, duration of the hyperbilirubinemia, and additional bilirubin measurements.


RESULTS
We showed significantly lower mean values of hemoglobin, erythrocytes and hematocrit and significantly higher values of reticulocytes in the group of ABO/Rh incompatibility compared to the group of jaundice of unspecific etiology; also an earlier presentation and a higher-grade jaundice in this group.


CONCLUSIONS
The laboratory profile in ABO/Rh isoimmunisation cases depicts hemolytic mechanism of jaundice. These cases carry a significant risk for early and severe hyperbilirubinemia and are eligible for neurodevelopmental follow-up. Hematological parameters and blood grouping are simple diagnostic methods that assist the etiological diagnosis of neonatal hyperbilirubinemia.
University Pediatric Clinic - Neonatology, Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia.
Anet Papazovska
AP
Cherepnalkovski
University Hospital Split and School of Medicine, University of Split, Split, Croatia.
Vjekoslav
V
Krzelj
Institute of Epidemiology and Biostatistics, Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia.
Beti
B
Zafirovska-Ivanovska
Institute for Clinical Biochemistry, Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia.
Todor
T
Gruev
University Hospital Split and School of Medicine, University of Split, Split, Croatia.
Josko
J
Markic
University Pediatric Clinic - Neonatology, Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia.
Natasa
N
Aluloska
University Pediatric Clinic - Neonatology, Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia.
Nikolina
N
Zdraveska
University Pediatric Clinic - Neonatology, Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia.
Katica
K
Piperkovska
ABO/Rh isoimmunisation; hemolytic jaundice; laboratory; unspecific etiology