THE PATTERN OF Rh & ABO HEMOLYTIC DISEASE OF THE NEW BORN IN TIKUR ANBESSA SPECIALIZED HOSPITAL NEONATAL ICU, ADDIS ABABA, ETHIOPIA

Alloimmune hemolytic disease of the new born is a major morbidity and health problem of the neonates. Currently, there are no tests in common clinical usages that can make the diagnosis of hemolysis reliably. To describe the pattern of alloimmune hemolytic disease of the newborn and mode of therapy and assess outcome of management of these neonates in pediatric and child health department, faculty of medicine, Addis Ababa University, neonatal ICU. A retrospective descriptive study of HDN cases admitted to department of pediatric and child health, neonatal intensive care unit, from September 1, 2006 to August 30, 2009, was conducted. Data were collected from the charts using prepared questionnaire and then analyzed. Neonates with Rh incompatibility disease and ABO incompatibility disease were 17.9% and 80.1% respectively. The number of neonate with first birth order was110 (54.7%) and as birth order increases, a decrement in frequency of ABO incompatibility disease was noted. Hyperbilirubinemia (serum bilirubin>/=20) was seen in 70(34.8%)of neonates and 171(85%) patients had anemia of varying severity at presentation, but the remaining 40(15%) were presented with jaundice without anemia. Reticulocyte count of > 5% was found in 26(28.5%) neonates and polychromasia was found in 32(29.6%). Direct coombs test was positive in 8(7.5%) of the neonates. Phototherapy was rendered to113 (56.2%) and double volume exchange transfusion was done on 88(43.8%) of the patients. With these measures, majority of them 189(92.7%) got improved and discharged, 12 (6.3%) patients were died. Alloimune hemolytic disease of the newborn is a significant problem of the neonates and can be caused by ABO (A, B, AB, or O) and Rh incompatibility. These newborns can be efficiently managed at large with phototherapy and in some with double volume exchange transfusion.