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Pediatrics Education and Research

Volume  6, Issue 3, Sep-Dec 2018, Pages 151-154
 

Original Article

Thrombocytopenia after Phototherapy for Indirect Hyperbilirubinemia among Breastfed Term and Preterm Neonates

Jayendra R. Gohil1, Chirag D. Gilitwala2, Sonal V. Jindal3

1Professor 2,3 Resident, Department of Pediatrics, Govt. Medical College, Sir T G Hospital, Bhavnagar, Gujarat 364002, India.

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DOI: https://dx.doi.org/10.21088/per.2321.1644.6318.3

Abstract

Objective: To compare the incidence of thrombocytopenia in breastfed term and preterm neonates with unconjugated hyperbilirubinemia receiving phototherapy. Material and Methods: A prospective study was done over a period of 5 months in NICU of a tertiary care hospital; 64 breastfed term and preterm (≥34 - <37 week) neonates with unconjugated hyperbilirubinemia requiring phototherapy were selected for the study after applying inclusion and exclusion criteria. Serum bilirubin and platelet count were sent on admission, after 24 hours and 48 hours of phototherapy. Phototherapy was administered according to AAP criteria, using LED phototherapy
(10 bulbs) positioned within 15 - 20 cm of the patient’s body. It was interrupted only for feeding and nursing for around 20 minutes every two to three hours. Platelet count and total serum bilirubin levels, before and after 24 and 48 hours of phototherapy were estimated. Results: After 24 to 48 hours of phototherapy, neonates showed statistically significant decrease in the platelet count; term (2.38 to 2.07 x 109/L, p = 0.0245) and preterm (2.27 to 1.96 x 109/L, p=0.0177), along with expected decrease of serum bilirubin levels. There was no association in the incidence of thrombocytopenia between the gestational age (term vs preterm, 6/32 vs 9/32 babies, p= 0.4741). Conclusion: Thrombocytopenia does occur following phototherapy in neonates. However it is clinically insignificant and asymptomatic. Gestational age of the neonate is not a factor associated with the incidence of thrombocytopenia after phototherapy in neonates with unconjugated hyperbilirubinemia.


Keywords : Thrombocytopenia; Indirect Hyperbilirubinemia; Phototherapy; Neonates; Platelet Count.
Corresponding Author : Sonal V. Jindal, Resident, Department of Pediatrics, Govt. Medical College, Sir T G hospital, Bhavnagar, Gujarat 364002, India.