Neonatal - jaundice Flashcards
% of neonates affected by jaundice
60%
complication with severe jaundice
kernicterus
2 main treatments
phototherapy
exchange transfusion
hyperbilirubinaemia after 24 hrs - normal or abnormal?
mostly physiological/normal
hyperbilirubinaemia after 24 hours causes (4)
shorter RBC lifespan
decreased conjugation - hepatic immaturity
absence of gut flora impedes elimination bile pigment
exclusive breastfeeding
causes of jaundice within 24 hours of birth
always abnormal
- sepsis
- ABO incompatibility
- spherocytosis/G6PD deficiency
- rhesus haemolytic disease - positive DCT
investigating jaundice in first 24 hours
FBC, film, blood groups, coombs
What is prolonged jaundice?
not fading 14 days term, 21 days prem
causes of prolonged jaundice
breastfeeding sepsis- UTI and TORCH hypothyroidism CF biliary atresia
side effects of phototherapy
temperature, eye damage, diarrhoea, fluid loss
what is exchange transfusion?
warm blood given through umbilical vein with removal umbilical artery
features kernicterus
lethargy
poor feeding
hypertonicity
shrill cry
do RBC release conjugated or unconjugated bilirubin?
unconjugated
where is bilirubin conjugated?
liver
2 excretion pathways for conjugated bilirubin
via biliary system to GI tract
urine
