Design of medical

1. Akash Rao
87-A

2. CLINICAL History
• A Baby Girl of 3 days born to a 30yr old mother after the
completion of 38 weeks gestation. During delivery baby .
• Within first 24-48hrs. Baby skin looking Pale and lethargy.

3. EXAMINATION
• On Examination
• Gender – F
• Bwt. - 2.5kg
• Ballard score – 8-9
• Respiratory Rate -70/min
• Chest retraction- moderate

4. Physical Examination
• Jaundice Assessment - The baby skin is pale
• Blood Test- The baby blood type is different from the mother that
leads to conformation that it is Rh-incompatibility and mother blood
antibodies attacking the baby RBCs.
• Hemoglobin level : 17g/dL

5. Identified risk Factors to put Diagnosis
• Maternal blood type –For confirmation of Rh-Incompatibility that is
Mother blood is Rh-negative and baby is Rh-Positive.
• Previous pregnancy.
• Blood Transfusion
• Maternal age
• Delayed Umblical Cord Clamping
• MATERNAL INFECTION

6. PRELIMINARY DIAGNOSIS
• Blood test to assess the baby bilirubin level blood type and
hemoglobin level.
• Treatment include Phototherapy, exchange transfusion and other
supportive measures to manage and prevent complications.

7. Additional Test
• Coombs Test –Detection of antibodies that causes Hemolysis
• Ultrasound- performed on baby spleen liver and other organ
• Exchange Transfusion.
• Phototherapy

8. Laboratory Result
• CBC : Hb- 8-10g/dl
• RBC- 2.0×10¹²
• Positive combs Test leads to conformation of haemolysis.
• Direct antiglobulin test – conform antibodies that destroy baby rbc.

9. Management
• Phototherapy
• Exchange Transfusion
• Blood Transfusion
• Intravenous immunoglobulin
• Close monitoring