Frequency, Etiology, and Complications of Neonatal Exchange Transfusion: A Prospective Cross-Sectional Study

Background: Neonatal hyperbilirubinemia is one of the most prevalent neonatal risk factors for neurological development disorders in pre-term and full-term babies. Despite being an invasive procedure, blood exchange transfusion (ET) is still the most effective procedure in reducing total serum bilirubin levels after the failure of phototherapy.Objective: This study aims to detect the various complications of ET and its frequencies among neonates admitted to the neonatal Intensive Care Unit (ICU) in a tertiary hospital.Methods: A prospective cross-sectional study included neonates of gestational age ≥ 35 weeks and had ET. ET was done using a single catheter pull-push technique via insertion of an umbilical venous catheter with documentation of etiology, routine laboratory tests, and associated complications of ET.Results: 118 neonates had ET and were recruited in our study. The most common causes for ET were due to hyperbilirubinemia of ABO incompatibility (61.9%), and 22.9% were due to Rh disease. The glucose-6-phosphate dehydrogenase deficiency (G6PD) participated in 8.5% of ET among our cases, and 6.8% were due to other causes. The incidence of complications due to ET occurred in 20 (16.9%) of cases. The most prevalent complication of ET was thrombocytopenia, which was presented in 7 (5.9%) of cases, and two cases died.Conclusion: Complications of ET were less frequent; thrombocytopenia was the most prevalent, followed by electrolyte disturbances. Neonatal mortality due to ET was very rare.