الفهرس 
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Abstract
This is a prospective cross sectional study included the neonates who were underwent ET of blood in NICU at Assiut University Children Hospital during the period from March 2018 till end of February 2019.
The aim of our study is to evaluate neonatal hyperbilirubinemia requiring ET, and to detect the various complications of ET and its frequencies among neonates admitted to NICU of Assiut University children hospital (AUCH).
• Inclusion criteria:
1. Neonates delivered of a gestational age ≥ 35 weeks and indicated for ET.
2. Neonates suffering from hyperbilirubinemia of any etiology, when phototherapy fails to prevent rise in bilirubin to toxic levels.
3. Neonates suffering from hemolytic disease of the newborn (ABO and Rh incompatibility) if;
Cord bilirubin level is >4.5 mg/dl and the cord hemoglobin (Hb) level <11 gm/dl.
Hemoglobin (Hb) level is between 11-13 gm/dl.
Bilirubin increasing >1 mg/dl/hr despite phototherapy.
• Exclusion criteria:
1. Preterm infants born < 35 weeks gestation.
2. Neonates whose parents refused participation in the study.
3. Sick neonates with other comorbidities.
Summary of our results; A total of 118 neonates underwent ET during the study period, and were included.
Demographics of our patients showing; 62.7% of our neonates were males, 69.5% were exclusively breast feeding and 57.6% were delivered by normal vaginal delivery.
The etiology of exchange transfusion was prevalent more among ABO incompatibility cases (61.9%), 22.9% in Rh incompatibility disease, 8.5% in G6PD and 6.8% due to other causes like sepsis, electrolyte imbalance, polycythemia or breast milk jaundice.
The prevalence of exchange transfusion was distributed as 74.6% had exchange transfusion for once, 22.0% had exchange transfusion twice and 3.4% had triple times exchange transfusion.
Our results can be summarized as 83.1% of our neonates had no complications for exchange transfusion, while 16.9% had associated complications.
Regarding the outcomes of the studied cases; a total of 6.8% were developing kernicterus, two infants died and at final 91.5% were discharged well.
The most prevalent exchange transfusion complications were thrombocytopenia (5.9%), followed by electrolyte disturbances, where hypocalcemia was prevalent in 2.5% and hypoglycemia in 1.7% of our patients.
The rare associated complications of exchange transfusion were sepsis (0.8%), apnea and/or bradycardia in 1.7% and hyponatremia (0.8%), and death were present in 2 (1.7%) of our cases.