Paeds Cases · fetal-neonatal-and-perinatal
A jaundiced infant at 12 hours of an RhD-sensitised pregnancy — OSCE
OSCE on the neonatal management of haemolytic disease of the newborn, testing first-24-hour jaundice recognition, the hour-specific nomogram, the phototherapy-IVIG-exchange ladder, and the prevention of bilirubin neurotoxicity.
On this page
Study tools
Target exams
Candidate brief
You are the neonatal registrar reviewing a term infant 12 hours after birth. The mother is Rh-negative with a known anti-D antibody from a previous pregnancy; she received antenatal care and the pregnancy was monitored with MCA-PSV Doppler. The infant's birth weight is 3300 grams, the temperature is 36.8 degrees, and the infant is visibly jaundiced to the mid-trunk. The cord blood shows a positive direct antiglobulin test, a haemoglobin of 105 g per litre, and the serum bilirubin is 220 micromoles per litre and rising. The infant is alert and feeding. [5]
References4ShowHide
- [4]Mari G, Norton ME, Stone J, Berghella V, Sciscione AC, Tate D, Schenone MH Society for Maternal-Fetal Medicine (SMFM) Clinical Guideline #8: the fetus at risk for anemia--diagnosis and management. Am J Obstet Gynecol, 2015.PMID 25824811
- [5]American Academy of Pediatrics Subcommittee on Hyperbilirubinemia Management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. Pediatrics, 2004.PMID 15231951
- [6]Maisels MJ, Newman TB, Kaplan M A new hour-specific serum bilirubin nomogram for neonates ≥35 weeks of gestation. J Pediatr, 2021.PMID 34265340
- [8]Zwiers C, Scheffer-Rath ME, Lopriore E, de Haas M, Liley HG Immunoglobulin for alloimmune hemolytic disease in neonates. Cochrane Database Syst Rev, 2018.PMID 29551014