Download PDF
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)

Also available at
    Permissions and Reprints

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.

KEYWORDS

Isoimmune hemolytic disease - hyperbilirubinemia - premature

REFERENCES

  • 1 Weiner C P. Human fetal bilirubin level and fetal hemolytic disease.  Am J Obstet Gynecol. 1992;  166 1449-1454
    PubMedSearch in Google Scholar
  • 2 Bernstein R, Novy M, Piaseki G. Bilirubin metabolism in the fetus.  J Clin Invest. 1969;  48 1678-1688
    PubMedSearch in Google Scholar
  • 3 Gartner L, Lane D. Hepatic metabolism and transport of bilirubin during physiologic jaundice in the newborn rhesus monkey.  Pediatr Res. 1971;  70 413
    PubMedSearch in Google Scholar
  • 4 Laster R, Behrman R, Lucey J. Transfer of bilirubin-C14 across placenta.  Pediatrics. 1963;  32 416-419
    PubMedSearch in Google Scholar
  • 5 Schmid R, Buckingham S, Mendilla G, Hammaker L. Bilirubin metabolism in the fetus.  Nature. 1959;  185 1823-1824
    PubMedSearch in Google Scholar
  • 6 Schenker S, Schmid R. Excretion of C14-bilirubin in newborn guinea pigs.  Proc Soc Exp Biol Med. 1964;  115 446-448
    PubMedSearch in Google Scholar
  • 7 Schenker S, Dawber N, Schmid R. Bilirubin metabolism in the fetus.  J Clin Invest. 1964;  43 32-39
    PubMedSearch in Google Scholar
  • 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
    PubMedSearch in Google Scholar
  • 9 Creasy R, Resnik R. Maternal-Fetal Medicine, 4th ed. Philadelphia; W.B. Saunders 1999: 746-749
    Search in Google Scholar
  • 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
    PubMedSearch in Google Scholar
  • 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
    PubMedSearch in Google Scholar
  • 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
    CrossrefPubMedSearch in Google Scholar

Horacio OsiovichM.D. 

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

4480 Oak Street, Vancouver

BC, Canada V6H 3V4