Does Prophylactic Phototherapy Prevent Hyperbilirubinemia in Neonates with ABO Incompatibility and Positive Coombs' Test?

Abstract

Prophylactic phototherapy was associated with a significant reduction of TSB in the first 48 hours of life but not later on. Clinical benefits of this strategy could not be proven.

Intravenous Immunoglobulin G Treatment in ABO Hemolytic Disease of the Newborn, is it Myth or Real?

“…When total bilirubin exceeds 95th percentile on the hour specific Bhutani nomogram phototherapy should be started immediately. Although prophylactic phototherapy was found to be effective in decreasing bilirubin level in the first 48 h of life, it did not result in a sustained clinical benefit so phototherapy is recommended as a rescue therapy rather than prophylactic treatment [8]. IVIG has been used for the treatment of alloimmune thrombocytopenia and neonatal infections [9,10].…”

Survey of management of neonatal haemolytic jaundice in Australasia

“…Phototherapy is now a viable alternative to the planned use of ET in the treatment of even moderate to severe HDN, 10 and as devices continue to develop and improve, phototherapy will play an even greater role in the treatment of HDN. The role of prophylactic phototherapy in the management of isoimmunised haemolytic disease is contentious, and no particular evidence is available to support its routine use 11 …”

“…The role of prophylactic phototherapy in the management of isoimmunised haemolytic disease is contentious, and no particular evidence is available to support its routine use. 11 In the present phototherapy era, the indications for early ET are variable and no consensus is available, 12 so it was not surprising the same was encountered in the practice of the various neonatal units. The use of albumin transfusion prior to ET has been explored before with no definitive answer, 13,14 and no specific practice was noted here.…”

Hemolytic Disorders of the Newborn, Current Methods of Diagnosis and Treatment: A Review Study

“…• Help for respiratory distress using oxygen or a mechanical breathing machine • Phototherapy: Intensive phototherapy has also been used to treat moderate and severe hemolytic disease of the newborn and decrease the need for exchange transfusion. The newborn is placed under a "blue light" which chemically alters the bilirubin in the surface capillaries to a harmless substance [63,64] • Exchange transfusion to replace the baby's damaged blood with fresh blood: The exchange transfusion helps increase the red blood cell count and lower the levels of bilirubin. An exchange transfusion is done by alternating giving and withdrawing blood in small amounts through a vein or artery…”