A 3 kg boy was born at 38 weeks following spontaneous vaginal delivery. The mother was a healthy 30 year old G3P1 with O+ blood type. Maternal laboratory findings were within normal limits and included a negative antibody screen. There was no significant family medical history, specifically no known history of jaundice, anemia or hematological disorders.
APGARS at birth were normal but within 3 hours of birth, the baby presented in acute respiratory distress with a feeble pulse, marked jaundice, pallor and cyanosis, with a whole body purpuric rash.
Laboratory Investigation Revealed:
Hemoglobin - 112 g/L
WBC - 22.7 x 109/L
Platelet Count - 25 x 109/L;
Reticulocytes - 8.5%
The baby died on the first day of life due to acute bilirubin encephalopathy.