Neonatal Jaundice Flashcards
What can cause unconjugated neonatal jaundice?
Physiological jaundice Dehydration Haemolytic disease Sepsis G6PD deficiency
What is key about conjugated neonatal jaundice?
Always pathological
What can cause conjugated neonatal jaundice?
Biliary atresia Alpha 1 antitrypsin deficiency Hypothyroidism Metabolic disorder Perinatal asphyxia
What can cause jaundice in a baby <24 hours old?
Haemolytic disease
TORCH infections
What are TORCH infections?
Toxoplasmosis Other (varicella, trepona pallidum, parvovirus b19) Rubella CMV Herpes
What can cause jaundice in a baby 24 hours - 2 weeks old?
Physiological jaundice Breast milk jaundice Infection Haemolysis Bruising
What can cause jaundice in a baby >2 weeks old?
Breast milk jaundice Infection Hypothyroidism Haemolysis Biliary atresia
What investigations should be done with a baby with jaundice?
Bilirubin
- transcutaneous bilirubinometer
- blood
FBC
Blood film
DCT
Blood/urine cultures
How is jaundice managed?
Feeding support
Phototherapy
IV IG
Exchange transfusion
How does phototherapy work?
Turns bilirubin into water soluble isomers that can be eliminate without conjugation
How does IV IG work?
Prevents further RBC breakdown in haemolytic disease
What is the definition of prolonged jaundice?
> 14 days in a term infant
> 21 days in a preterm infant
What is a risk of prolonged jaundice?
Kernicterus
What is kernicterus?
Bilirubin encephalopathy
What happens in kernicterus?
Bilirubin crosses the BBB and is deposited in the basal ganglia
