Am J Perinatol 2004; 21(8): 427-431
DOI: 10.1055/s-2004-835958
Copyright © 2004 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

A Case of Extreme Unconjugated Fetal Hyperbilirubinemia

Fahad AlAql1 , Horacio Osiovich1
  • 1Division of Neonatology, Children's and Women's Health Centre of British Columbia, and Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
Further Information

Publication History

Publication Date:
28 October 2004 (online)

ABSTRACT

We present an unusual case of severe unconjugated hyperbilirubinemia and normal hemoglobin at birth in a premature newborn with Rh incompatibility. We speculate that the possible mechanism is due to placental dysfunction. To our knowledge, this is the highest reported unconjugated bilirubin level at birth.

REFERENCES

  • 1 Weiner C P. Human fetal bilirubin level and fetal hemolytic disease.  Am J Obstet Gynecol. 1992;  166 1449-1454
  • 2 Bernstein R, Novy M, Piaseki G. Bilirubin metabolism in the fetus.  J Clin Invest. 1969;  48 1678-1688
  • 3 Gartner L, Lane D. Hepatic metabolism and transport of bilirubin during physiologic jaundice in the newborn rhesus monkey.  Pediatr Res. 1971;  70 413
  • 4 Laster R, Behrman R, Lucey J. Transfer of bilirubin-C14 across placenta.  Pediatrics. 1963;  32 416-419
  • 5 Schmid R, Buckingham S, Mendilla G, Hammaker L. Bilirubin metabolism in the fetus.  Nature. 1959;  185 1823-1824
  • 6 Schenker S, Schmid R. Excretion of C14-bilirubin in newborn guinea pigs.  Proc Soc Exp Biol Med. 1964;  115 446-448
  • 7 Schenker S, Dawber N, Schmid R. Bilirubin metabolism in the fetus.  J Clin Invest. 1964;  43 32-39
  • 8 Brace R, Gilbert W, Thornburg K. Vascularization of the ovine amnion and chorion: a morphometric characterization of the surface area of the intermembranous pathway.  Am J Obstet Gynecol. 1992;  167 1747-1755
  • 9 Creasy R, Resnik R. Maternal-Fetal Medicine, 4th ed. Philadelphia; W.B. Saunders 1999: 746-749
  • 10 Weiner C, Williamson R, Wenstrom K, Sipes S, Grant S. Management of fetal hemolytic disease by cordocentesis: I. Prediction of fetal anemia.  Am J Obstet Gynecol. 1991;  165 546-563
  • 11 MacKenzie I, Bowel P, Castle B, Selinger M. Serial fetal blood sampling for the management of pregnancies complicated by severe rhesus (D) isoimmunization.  Br J Obstet Gynaecol. 1988;  95 753-758
  • 12 Mari G. Noninvasive diagnosis by Doppler ultrasonography of fetal anemia due to maternal red-cell alloimmunization.  N Engl J Med. 2000;  342 9-14

Horacio OsiovichM.D. 

Division of Neonatology, Children's and Women's Health Centre of British Columbia

4480 Oak Street, Vancouver

BC, Canada V6H 3V4

    >