Neonatal Jaundice Flashcards
What is the percentage of term neonates which have physiological jaundice in the first week of life?
60%
What is the condition that prolonged jaundice can cause?
Kernicterus-Basal ganglia
Neonatal pathological jaundice is found at
1 day of age
Neonatal prolonged jaundice is found at
14 days of age
What is jaundice?
Bilirubin-red blood cell (albumin) - fetus have high haemoglobin and break down after being able to respirate on their own. RBC’s are then broken down and bilirubin part is transported with albumin to the liver
Liver: unconjugated to conjugated bilirubin → from fat-soluble to water-soluble
Energy and oxygen
What is physiological jaundice?
Days 3-5
Intestines reabsorption of bilirubin: meconium needs to be passed if there is a delay of excretion, bilirubin could be re-absorbed.
How do you evaluate jaundice?
Maternal blood group: to know if mother is rhesus neg or O -/+
Sepsis: a baby fighting sepsis is using their energy stored to do so. So will not have enough energy to remove bilirubin
Bruising: difficult birth. More blood cells are damaged
Gestation: liver of 37w baby is not mature enough to deal with breaking down bilirubin. 37 weeks will have a different chart. Bilirubin levels are plotted in hours
Age of baby: age in hours
Ethnic origin: G6PD -make assessment of ethinic by looking at parents
Feeding history
Passed meconium
Previous sibling: if previous baby has had jaundice and phototherapy
How do you measure jaundice?
Age of baby
Gestation
Bilirubinometer: sternum of the baby and can only be used in term babies
SBR
Risk factors for neonatal jaundice
G6PD
ABO incompatibility
Rhesus disease
What does phototherapy consist of?
Parental concerns Equipment Eye protection Temperature control Dehydration-loose stools Nutrition and hydration Mother-infant interaction Bili blanket
