Neonatal Jaundice

Question 1

When is neonatal jaundice considered pathological?

Answer 1

Within first 24 hours
Over 95th percentile
Persists beyond 2-3 weeks

Question 2

What are some major risk factors for neonatal jaundice

Answer 2

Prematurity
Jaundice in first 24 hours
Blood group incompatibility
Previous sibling needed phototherapy
Cephalohaematoma or significant bruising
Exclusive breastfeeding
East Asian ethnicity

Question 3

What are minor risk factors for neonatal jaundice

Answer 3

Macrosomic infant of diabetic mother
Polycythaemia
Male gender
Maternal age older than 25

Question 4

What are the signs of bilirubin encephalopathy

Answer 4

Poor feeding
Lethargy
Altered sleep
Abnormal tone
Seizures
15% asymptomatic in newborn period

Question 5

What type of bilirubin is most commonly associated with neonatal jaundice and why?

Answer 5

Unconjugated
Excess RBC breakdown

Question 6

What blood test should you do to investigate neonatal jaundice?

Answer 6

Total serum bilirubin
Can differentiate unconjugated from conjugated

Question 7

What are the management options for unconjugated hyperbilirubinaemia?

Answer 7

Phototherapy 1st line
Exchange transfusion 2nd line

Can do IvIg if immune mediated

Question 8

What is the management of biliary atresia?

Answer 8

Kasai operation (hepatic portoenterostomy) within 2 months