Neonatal jaundice Flashcards
What measure is used to assess neonatal jaundice?
Bilirubin levels
How are bilirubin levels measured in an infant more than 35 weeks or more than 24 hours old?
Transcutaneous bilirubinometer
How are bilirubin levels measured in an infant less than 35 weeks or less than 24 hours old?
Serum bilirubin
When should neonatal jaundice be treated?
When levels are above the gestation specific threshold
When is neonatal jaundice pathological?
Within the first 24 hours of life
When the jaundice develops after the first 24 hours of life but persists for more than 2 weeks
What can excessive bilirubin levels in the newborn cause?
Kernicterus
What is kernicterus?
A type of brain damage that presents with a floppy baby and poor feeding
How does kernicterus occur?
Bilirubin crosses the blood-brain barrier and causes direct damage to the CNS
What are the causes of prolonged jaundice?
Infection
Metabolic problems - hypothyroidism, hypopituitarism, galactosaemia, alpha-1-antitrypsin
Biliary atresia
Haemorrhage
Breast milk jaundice
Polycythaemia
Haemolytic disease of the newborn
What are the red flags in a newborn with jaundice?
Pale stools
Dark urine
Febrile
Significant weight loss in the first week of life
Significant bruising
Lethargy
Poor feeding
What is haemolytic disease of the newborn?
Haemolysis caused by an incompatibility of the rhesus antigens of mother and baby
What is the first line treatment of neonatal jaundice?
Phototherapy
What is phototherapy?
Phototherapy involves shining the baby with blue light that breaks down unconjugated bilirubin into isomers that can be excreted in the urine
When can phototherapy be stopped?
Once the child is more than 50 micromoles/L less than the threshold
After starting phototherapy, how often should bilirubin levels be monitored?
Every 4-6 hours
