Jaundice in the Newborn Period

Question 1

What are the causes of jaundice <24 hours?

Answer 1

• Haemolytic Disease of the Newborn
  
  • rhesus haemolytic disease
  • ABO haemolytic disease
  • hereditary spherocytosis
  • glucose-6-phosphodehydrogenase
• Infection - TORCH
• Autoimmune haemolytic anaemia
• Crigler-Najjar syndrome - inherited condition - unable to conjugate bilirubin.
• Gilbert’s syndrome

Question 2

What are the causes of jaundice between 24 hours to 3 weeks after birth?

Answer 2

• Physiological jaundice
• Breast milk jaundice
• Infection
• Haemolysis
• Bruising
• Polycythaemia
• Crigler-najjar syndrome

Question 3

What are the causes of prolonged jaundice (>3 weeks after birth)?

Answer 3

• Physiological jaundice
• Breast milk jaundice
• Infection - UTI, congenital infections - TORCH.
• Hypothyroidism
• Biliary atresia
• Haemolytic anaemia
• GI obstruction

Question 4

If there is janudice after 14 days, what invetigations should be done?

Answer 4

• Conjugated and unconjugated bilirubin: the most important test as a raised conjugated bilirubin could indicate biliary atresia which requires urgent surgical intervention
• Direct antiglobulin test (Coombs’ test)
• TFTs
• FBC and blood film
• Urine for MC&S and reducing sugars
• U&Es and LFTs