Treatment of ABO hemolytic disease with synthetic blood group trisaccharides.

Thirteen infants, 10 with A-O and 3 with B-O hemolytic disease of the newborn (ABO-HDN), were treated with synthetic A or B blood group trisaccharides (ATS, BTS) which cause dissociation of maternal antibody bound to infant red cells. The clinical outcome was compared with that of a control group of 21 infants treated with phototherapy during the preceding year. Exchange transfusion was required in 2 out of 13 infants in the experimental group and in 7 in the control group. A randomized prospective controlled study is necessary to confirm these results.

Neonatal jaundice. A second 4-year experience in Toa Payoh Hospital (1986-1989).

A 4-year experience of neonatal jaundice, from 1982-1985, in Toa Payoh Hospital, Singapore was reported previously. The second 4-year experience (1986-1989) of neonatal jaundice is reported. The Department had a more liberal policy in the management of milder cases of neonatal jaundice since 1986, after acquisition of more phototherapy units. It is the purpose of this paper to examine the change in pattern of neonatal jaundice in the same department over these 2 study periods and a comparison is made. The reported frequency of neonatal jaundice in these 2 study periods rose from 7.9% to 10% of all babies in this hospital. Babies who have some form of treatment such as phototherapy are considered as cases of neonatal jaundice. However, the incidence of hyperbilirubinaemia (defined as serum bilirubin level of 255 umol/L or 15 mg/dl or greater) fell from 3.23% to 2.11% of all livebirths in these 2 study periods. ABO Incompatibility, glucose-6-phosphate dehydrogenase (G6PD) deficiency and low birth weights (LBW) remain as the common aetiological factors of neonatal jaundice. The indications of exchange blood transfusions have changed considerably. There were less exchange blood transfusions for severe neonatal jaundice due to G6PD deficiency. However, more LBW babies underwent exchange blood transfusion. No case of kernicterus was reported for more than 10 years.