Neonatal jaundice Flashcards
definition: conjugated hyperbilirubinemia
serum direct bilirubin over 2 mg/dL
serum direct bilirubin over 20% of total
jaundice appears at what bilirubin concentration in the newborn?
serum bilirubin over 5 mg/dL
what are the risk factors for neonatal jaundice?
male vacuum / forceps maternal fever / GBS diabetes maternal blood type O maternal Rh neg previous infants with jaundice excessive bruising asian breastfeeding prematurity
how does gestational age relate to risk of hyperbilirubinemia?
the younger the gestational age, the higher the risk
when does jaundice usually occur in the neonatal period?
2nd to 5th day
jaundice occurs in what % of neonates?
50-60%
what are the exclusion criteria for physiologic jaundice?
unconjugated over 13 mg/dL in term unconjugated over 15 mg/dL in preterm increase of over 5 mg/dL in 24 hours jaundice in first 24 hours of life jaundice lasting over a week in term jaundice lasting over 2 weeks in preterm
what is recommended to help resolve and prevent neonatal hyperbilirubinemia?
frequent feedings
what is the most common cause of hemolytic anemia in the newborn?
ABO incompatibility
ABO incompatibility occurs in what % of pregnancies? what about sensitization? significant hemolysis?
incompatibility - 12%
sensitization - 3%
hemolysis - 1%
how is breast milk jaundice different from breast feeding jaundice?
breast feeding - lack of calories coming in
breast milk - factor in mothers breast milk
what are the diagnostic criteria for breast milk jaundice?
well feeding
2nd week of life
breast feeding
what is the treatment for breast milk jaundice?
self-resolving
feed formula for two days
bilirubin abnormality is assessed by what type of plot? what is it good for?
nomogram
predicting when you need to follow up
when is follow up performed for low to high intermediate risk hyperbilirubinemia?
2-3 days
