Summary
https://doi.org/10.1093/clinchem/hvac077
A male baby was prematurely born by an emergency cesarean section at 34 + 1 weeks following a diagnosis of placental abruption. The newborn had a history of intrauterine growth restriction, cardiomegaly, a biometry lower than the 5th percentile of physiological distribution, and weighed 2000 g at birth. The Apgar score at 1, 5, and 10 min after birth was 5, 7, and 8, respectively. Due to bradycardia and difficult spontaneous breathing, the infant was immediately resuscitated and transferred to the neonatal intensive care unit (NICU). He was ventilated with nasal continuous positive airway pressure (60% O2) and treated with surfactant. Laboratory evaluations performed at NICU admission showed a negative direct Coombs test, a borderline low blood hemoglobin concentration (134 g/L; reference interval [RI]: 135–220 g/L), a low platelet count (105 × 109/L; RI: 155–320 × 109/L), increased white blood cell (WBC) count (30.0 × 109/L; RI: 5.0–21.0 × 109/L), markedly increased nucleated red blood cell (NRBC) number (211 × 109/L; RI: <0.03 × 109/L), together with hyperbilirubinemia (total bilirubin [TBil], 7.49 mg/dL; RI: <5.00 mg/dL) for which phototherapy was immediately started. However, despite phototherapy, TBil concentrations rapidly increased.