Neonatal Flashcards
Direct hyperbilirubinemia
Direct bili > 1 Always BAD! Ex. Biliary obstruction ?TORCH infections Tx: Varies but NOT phototherapy because it can cause Bronze Baby Syndrome.
Indirect hyperbilirubinemia
Baby is not conjugating bili.
Tx: phototherapy
Causes: hemolysis (G6PD defic if male), hypothyroidism, genetic defect/enzyme deficiency (galactosemia, Crigler Najjar), some TORCH infections, sepsis, prematurity.
Older kid, in setting of illness: consider Gilbert syndrome (benign)
Hyperbilirubinemia in first 24 h of life
Always BAD!
Ex. TORCH infection or G6PD
Indications for phototherapy
For baby >35 weeks only:
tBili levels at 24h, 48h, 72h -
High risk baby (<38 wks plus risk factors): 8, 11, 13
Medium risk baby (<38 wks with no risk factors) or >=38 wks plus risk factors): add 2 (so 11, 13, 15)
Low risk baby (>38 wks): add 4 (so 12, 15, 17)
Risk factors: cephalohematoma, ABO or Rh incompatiblity, illness/disease (ex. Sepsis, temp instability, G6PD defic, acidosis), albumin<3, exclusive breastfeeding that is not going well, etc
Some word associations:
Rhesus disease
ABO incompatiblity
G6PD deficiency
Rh disease: maternal IgG crosses placenta during second pregnancy -> erythroblastosis fetalis. Mom needs Rhogam at 20 wks, baby at delivery. Kleihauer Betke test (fetal RBCs in mom’s blood)
ABO: hemolytic disease of newborn in first pregnancy
G6PD deficiency: fava beans. X-linked recessive (males affected). Heinz bodies. X marks the spot where you squeeze to get the ketchup to come out.
Some word associations:
Rhesus disease
ABO incompatiblity
G6PD deficiency
Rh disease: maternal IgG crosses placenta during second pregnancy -> erythroblastosis fetalis. Mom needs Rhogam at 20 wks, baby at delivery. Kleihauer Betke test (fetal RBCs in mom’s blood)
ABO: hemolytic disease of newborn in first pregnancy
G6PD deficiency: fava beans. X-linked recessive (males affected). Heinz bodies. X marks the spot where you squeeze to get the ketchup to come out.
Umbilical Cord catheters
L3-L6 or T6-T10
