Continous And Intermittent Phototherapy In The Management Of Neonatal Hyperbilirubinemia A Randomised Intervention Study

Abstract

BACKGROUND: Neonatal hyperbilirubinemia is a common and usually benign problem in neonates during the first week of life. Previous studies comparing intermittent versus continuous phototherapy for reducing neonatal hyperbilirubinemia have produced contradicting results. OBJECTIVES OF THE STUDY: To compare between intermittent and continuous phototherapy in reducing total serum bilirubin, rate of fall of bilirubin, duration of phototherapy and duration of hospitalisation in neonatal hyperbilirubinemia. MATERIALS AND METHODS: The study was a randomized interventional study done in neonates who got admitted in NICU who were >34 weeks, both genders, both normal and lower segment caesarean-section deliveries, birth weight ≥ 2000gm and APGAR score > 7/10 at 1 min were included in the study and randomised into group A (continuous phototherapy) & group B (intermittent phototherapy) based on treatment protocol. Rh incompatibility, ABO incompatibility, neonatal sepsis, any significant congenital malformation, Denial of consent were excluded from the studyRESULTS : In our study the mean serum bilirubin before the start of phototherapy was 15.64 ± 2.19 mg/dl for continuous and 15.03 ± 1.07 mg/dl for intermittent group, and the mean serum bilirubin at 12, 24, 48 hour was 13.26 ±2.4mg/dl, 10.8 ± 1.72 mg/dl, 10.16 ± 0.95mg/dl respectively for continuous and 12.6 ±1.65mg/dl, 10.04 ±1.8 mg/dl, 9.1 ± 0.66 mg/dl respectively for intermittent group, and mean rate of fall in serum bilirubin for continuous versus intermittent group was 0.22 ± 0.12mg/dl, 0.21 ± 0.08 respectively. CONCLUSION: Intermittent and continuous phototherapies were found to be equally effective. Because of the additional benefits of intermittent phototherapy, like nursing care of the baby, breast feeding, KMC care, building mother infant bonding, reducing work load on nurses , it can be followed as a routine method instead of continuous phototherapy in neonatal care units.