Hyperbilirubinemia Case Study

A thirty year old female presented to the delivery room with an uncomplicated vaginal birth. On examination, the baby girl was responsive, jaundiced, no dysmorphic features, and all vitals where normal. Blood bank results showed that the baby was O positive and had a strong positive direct anti-globulin (DAT) of a 4+. After having double phototherapy for thirty-six hours, the baby still had an increased reticulocyte count of 5.5 to 7.5 % and an increased bilirubin level of 7.0 to 18.0 mg/dL. The mother had two children previous of her newborn. Her first child had a blood type of O positive and a negative direct anti-globulin test. Her second child had a blood type of O positive as well but, had a positive direct anti-globulin test. After an Elution was done, removing any antibodies attached to the baby’s red blood cells, the second child resulted positive for anti-E and anti-c. He also developed hyperbilirubinemia after birth and responded well to phototherapy. The mother and the newborn …show more content…
Although, hyperbilirubinemia, hydrops fetalis, and anemia can also be a suspicion of hemolytic disease, these diagnosis can also be found in other diseases and conditions. There are specific tests that can help diagnose for hemolytic disease of the newborn. Maternal blood is tested for the presence of Rh positive antibodies, and also a procedure known as PUBS, percutaneous umbilical cord sampling, can be done during pregnancy to check for bilirubin, antibodies, anemia and if the baby needs a blood transfusion. An ultrasound can detect whether there is a buildup of fluid around the organs of the fetus, causing hepatomegaly and splenomegaly. A needle inserted into the mother’s abdomen during pregnancy, known as amniocentesis, can measure the amount of bilirubin that is in the amniotic fluid. All of these procedures ca be done prior to delivery (Center,