23. Đặc điểm lâm sàng, cận lâm sàng của trẻ sơ sinh vàng da tăng Bilirubin gián tiếp do bất do đồng nhóm máu mẹ tại Bệnh viện Nhi Trung ương

Abstract

Indirect hyperbilirubinemia (IHB) arising from maternal–infant blood group incompatibility is a major cause of severe hyperbilirubinemia and anemia in newborns. We conducted a descriptive case series of 147 neonates with IHB attributable to maternal–infant blood group incompatibility admitted to the Center for Neonatalology, Vietnam National Children’s Hospital from January 2024 to April 2025. Treatments included intravenous immunoglobulin (IVIG; n = 82), exchange transfusion (n = 29), and mono phototherapy (n = 36). The results showed that jaundice appeared early, predominantly within the first 24 hours after birth, most infants were term (83.0%), 53.7% had anemia and thereticulocyte percentage (%RET) was elevated, with a median of 9.1% (IQR, 4.5 - 12.7), and was higher in the IVIG and exchange-transfusion groups. ABO incompatibility was the predominant cause, accounted for 87.1% of cases, Rh incompatibility at 4.1%, and minor subgroup incompatibility at 8.8%. Maternal anti-A and anti-B antibody titers were elevated. IHB due to maternal–infant blood group incompatibility is characterized by early-onset jaundice within 24 hours after birth, with ABO incompatibility is the predominant cause and markedly elevated maternal anti-A/B antibody titers.