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A Comparative Study of Intensive Phototherapy Versus Conventional Phototherapy in Decreasing the Need for Exchange Transfusion in Neonatal Hyperbilirubinemia
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| Author:
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J.M.PAWAR , VINAYKUMAR NANDIMALLA
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| Abstract:
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Background: Phototherapy and exchange transfusion (ECT) are the mainstay treatments in neonatal hyperbilirubinemia. However, ECT is associated with morbidity and mortality. Hence, there is need to reduce the requirement of ECT.
Objective: To compare and assess the efficacy of intensive phototherapy and conventional phototherapy in decreasing the need for ECT in neonatal hyperbilirubinemia.
Methods: In this prospective comparative study 720 term (>37 weeks) neonates diagnosed with indirect hyperbilirubinemia were selected and allocated to study group (N=366) and control group (N=354). The study group received intensive phototherapy and controls received conventional phototherapy. ECT was performed in neonates unresponsive to phototherapy. Demographic data and clinical data such as total serum bilirubin (TSB), complete blood count (CBC), blood group and reticulocyte count were collected. The data were analyzed by SPSS 20.0. Mann Whitney U test, Odds ratio and proportion test were used to test statistical significance.
Results: ABO incompatibility was the most common reason for hyperbilirubinemia in the study. The odds of study group undergoing ECT is 20.23% less than the control group (P<0.05), which shows that intensive phototherapy had reduced the need for ECT. There was considerable reduction in TSB in study group (12.11±0.793 mg/dl) than control group (14.86±1.53 mg/dl) (P<0.001) and also the duration of phototherapy was considerably lower in study group (2.63±0.48 days) than the controls (3.49±0.50 days).
Conclusion: Hence, it can be concluded that intensive phototherapy is more effective at reducing the need for ECT than conventional phototherapy in term neonates with indirect neonatal hyperbilirubinemia.
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| Keyword:
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Newborn, Jaundice, Bilirubin, Phototherapy, Exchange Transfusion
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| EOI:
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| DOI:
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https://doi.org/10.31838/ijpr/2020.12.03.404
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| Download:
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