Fetal exposure to maternal hyperbilirubinemia. Neonatal course and outcome.

A case of prolonged fetal exposure to hyperbilirubinemia occurred in a mother with end-stage liver disease during the second and third trimester of pregnancy. At birth, the infant had elevated levels of both conjugated and unconjugated serum bilirubin that required multiple-exchange transfusions during the first three days of life. The infant exhibited abnormal neurologic findings at birth that resolved during the neonatal period. The results of subsequent developmental and neurologic evaluation were normal at 14 months of follow-up. Prolonged fetal exposure to elevated serum bilirubin levels may not necessarily result in developmental or neurologic handicap.