ABO System Incompatibility: Relationship Between Direct Coombs Test Positivity and Neonatal Jaundice

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Abstract
Recent evidence indicates that neonatal serum bilirubin levels much lower than 20 mg/100 ml may produce minor or even severe damage of the central nervous system, particularly when they are associated with other pathological situations.1-3 This information has prompted a more aggressive approach to neonatal jaundice aimed at the prevention rather than the therapy of severe hyperbilirubinemia. However, most of the proposed methods of treatment, including phenobarbital and phototherapy, present potential hazards for the infant and should, therefore, be used only in infants with a high risk of jaundice.4,5 Newborn infants incompatible with their mothers in the ABO system present a potentially higher risk of severe hyperbilirubinemia particularly in the presence of a positive direct Coombs test.

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