Moderate to Severe Hemolytic Disease of the Newborn in a Referral Centre in Saudi Arabia

All infants undergoing an exchange transfusion at King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia, during a 7½-year period, were studied retrospectively. One hundred thirteen exchange transfusions were performed in 57 infants. Of 45 infants with hemolytic disease, three were still newborn, The 42 liveborn infants required 93 exchange transfusion for hemolytic disease of the newborn. In 15 infants requiring 20 exchange transfusions, the indication was hyperbilirubinemia of prematurity. Rh-hemolytic disease of the newborn was the most common etiology of severe anemia or hypebilirubinemia requiring an exchange transfusion. Isoimmunization was due to anti-D in 34 patients, anti-c in three, and anti-E and anti-C in one, anti-A and anti-B in four and anti-Jk(b) in one patient. One of these cases of hemolytic disease of the newborn was due to G6PD deficiency, and in one case the cause was unknown, The incidence of moderate to severe Rh-hemolytic disease of the newborn was 7.0/1000 births contributing significantly to perinatal mortality (6.3%) and to early neonatal mortality (7.0%) in the hospital. Rh-hemolytic disease of the newborn is a problem in Saudi Arabia that could be reduced with improved antenatal and obstetric care and ante- and postnatal anti-D-globulin prophylaxis.