Study on Effectiveness of Adding Phenobarbitone to Conventional Therapy in Preterm Neonates with Unconjugated Hyperbiliurubinemia in Comparison with Conventional Therapy

Aim: To assess the effectiveness of adding prophylactic phenobarbitone to conventional therapy in preterm neonatal jaundice in reducing the incidence, peak serum bilirubin levels, duration and need of Phototherapy in the treatment and time taken for complete clearance of jaundice.

Background: Neonatal unconjugated hyperbilirubinemia is a life threatening. The conventional therapy is a long time process & some of neonate cannot tolerate for long-term phototherapy. Adding of phenobarbitone to the conventional therapy gives better results.

Study Design: A prospective observational study in comparison with retrospective data & it was conducted in the 6 months period i.e., from February 2015 to July 2015 at GGH guntur.

Methodology: In our study a 50 patients of both sex under prospective group to whom oral phenobarbitone was given 3 mg/kg/day and 50 patient case sheets data was analyzed under retrospective group. Preterm neonates admitted in neonatal intensive care unit with body weight >1 kg were included in the study and neonates who are on ventilator and birth weight <1kg were excluded from the study. Effectiveness of phenobarbitone was assessed by comparing prospective group with retrospective group using paired t-test in SPSS software.

Results and Discussion: Peak total serum bilirubine values, Duration of phototherapy, Duration of hospital stay were less in prospective group as compare with retrospective group were statistically significant. Peak TSB value was observed earlier in prospective group than in retrospective group and there was no requirement of exchange transfusion in prospective group. There was no requirement of phototherapy in 18 out of 50 neonates in prospective group.

Conclusion: We conclude that prophylactic oral phenobarbitone dose of 3 mg/kg/day ± phototherapy is effective in healthy preterm neonates in the treatment of unconjugated hyperbilirubinemia and the beneficial affect was more in Low birth weight neonates than in very low birth weight neonates as compare with phototherapy alone.