Neonatal Jaundice

Question 1

Risk fx

Answer 1

Jaundice <24hrs
Known hemolytic disease G6PD
GA <36 wks
Cephalohematoma/significant bruising
Exclusive BF -> decrease feeding
East Asian
Minor: GA 37-38 wks, Male, Maternal age >35, Sibling w jaundice

Question 2

Causes - First 24 hrs

Answer 2

Pathological:
Hemolysis: ABO incompatibility, G6PD def
Erythroblastis Fetalis - Hemolytic anaemia
Sepsis/congenital infection - TORCH

Question 3

Causes - Peak 24hrs - 14 days

Answer 3

Physiological -
Dehydration
Breast milk jaundice - dx exclusion
Bruising, birth trauma
Sepsis
Hemolysis

Question 4

Causes >2 weeks

Answer 4

Prolonged/Conjugated
Sepsis
Hemolysis
Dehydration
Breast milk jaundice - dx of exclusion
hypothyroidism

Question 5

Ix for Prolonged Jaundice

Answer 5

SBR - conjugated + unconjugated
Group + DAT
FBC, reticulocyte
LFT
TFT

Question 6

Treatment

Answer 6

Treat jaundice
- Biliblanket, lights : Phototherapy (bili 285-340)
- Exchange Transfusion (bili >340)

Treat underlying cause