Her presentation was ultimately explained with a diagnosis of both conditions, and required treatment with phenobarbitone. [ncbi.nlm.nih.gov]

There was therefore need for prompt recognition and treatment of septicaemia and efforts should be focused at the community level to encourage mothers to present early in hospital as soon as jaundice is noticed. [dx.doi.org]

• Falling

  36 > 225 > 400 42 > 237 > 450 48 > 250 > 450 54 > 262 > 450 60 > 275 > 450 66 > 287 > 450 72 > 300 > 450 78 > 312 > 450 84 > 325 > 450 90 > 337 > 450 96+ > 350 > 450 Action Start phototherapy Perform an exchange transfusion unless the bilirubin level falls [nice.org.uk]

  The bilirubin should fall by at least 30mmol/l within 4 hours and should continue to fall and remain below the level for exchange transfusion. Content by Dr Íomhar O' Sullivan 07/06/2005. Last review Dr ÍOS 19/01/15. [emed.ie]

  It falls rapidly in 48 hours if breast feeding is stopped. If breast feeding is continued, it stays elevated and slowly falls returning to normal by 4 to 12 weeks. It appears between 24-72 hours, peaks by 1-2 weeks and disappears by 3 rd week. [epomedicine.com]

  425 - 475 nm ) - Blue White Light Water insoluble bilirubin ------> Water Soluble -----> Excreted Mechanism: Structural Isomerization (Bilirubin to Lumirubin) (Irreversible) Photoisomerization Photo-Oxidation Child 40 cm away from tube. 4 - 6 mg/day fall [mediconotebook.com]

  […] breastfeeding (as do British "NICE" guidelines; BMJ 340:c2409, 2010-JW)and/or supplementing with expressed-breast-milk or formula in a bottle, though AAP acknowledges that cessation of breastfeeding and substitution of formula is ass'd with more rapid fall [faculty.washington.edu]

• Pneumonia

  The most common pathogen isolated from the UTI cases was Klebsiella pneumoniae. Also, unconjugated hyperbilirubinemia was detected in all jaundiced patients with UTI. [ncbi.nlm.nih.gov]

  Lungs are examined for crackles (rales), rhonchi, and decreased breath sounds (pneumonia). The abdomen is examined for distention, mass (hepatosplenomegaly), or pain (intestinal obstruction). [msdmanuals.com]

  Coomb's: hemolytic disease Other tests to consider include: G6PD levels TSH albumin If bilirubin is conjugated, consider: liver enzymes INR, PTT ammonia TORCH screen galactosemia metabolic screen Diagnostic Imaging A chest X ray may be done to assess for pneumonia [sharinginhealth.ca]

• Dyspnea

  Listing 1 - 6 of 6 Sort by Article Chest Radiographic Finding in Neonatal Dyspnea Loading... Loading... [iasj.net]

• Jaundice

  […] from pathologic jaundice. [msdmanuals.com]

  (Jaundice in Neonates) By Kevin C. [merckmanuals.com]

  Nurses were charged with assessment of jaundice, which was graded on a 0-5 scale, dependent on the extent of jaundice progression from head to hands and feet (cephalocaudal progression). [acutecaretesting.org]

  […] following factors: any neonate any neonate where there is clinical doubt about the degree of jaundice any unwell neonate with jaundice any neonate with risk factors for jaundice (ABO/ Rh incompatibility, sepsis, acidosis, asphyxia, hypoalbuminaemia) Ongoing [rch.org.au]

  […] terms physiologic jaundice and pathologic jaundice. [emedicine.medscape.com]

• Neonatal Jaundice

  Risk of developing significant neonatal jaundice is higher in male infants. [emedicine.medscape.com]

  Neonatal jaundice is the subject of two recent studies and an accompanying editorial, all published in the October issue of Archives of Disease in Childhood (Neonatal Edition). [acutecaretesting.org]

  Black race and maternal smoking were not protective against neonatal jaundice as in some other studies. CONCLUSION: More than half (55.2%) of healthy term neonates developed neonatal jaundice. [ncbi.nlm.nih.gov]

  […] with those without neonatal jaundice. [nature.com]

• Hearing Impairment

  Although 71.7% and 69.7%, respectively, of the mothers knew that severe jaundice could cause death and brain damage, only 38.4% of them were aware that severe jaundice could result in hearing impairment. [ncbi.nlm.nih.gov]

  impaired $70 $9.99 /1 Month Trial Let's do it! [onlinemeded.org]

  When monitored and treated in a timely manner, progression of severe hyperbilirubinemia can be curtailed and prevent kernicterus, a life long athetoid cerebral palsy and/or sensori-neural hearing impairment. [nature.com]

  Olusanya BO, Neumann KJ, Saunders JE: The global burden of disabling hearing impairment: a call to action. Bull World Health Organ 2014;92:367-373. Thaddeus S, Maine D: Too far to walk: maternal mortality in context. Soc Sci Med 1994;38:1091-1110. [karger.com]

• Yellow Discoloration of the Skin

  Engelsk definition Yellow discoloration of the SKIN; MUCOUS MEMBRANE; and SCLERA in the NEWBORN. It is a sign of NEONATAL HYPERBILIRUBINEMIA. [mesh.kib.ki.se]

  Definition Neonatal jaundice is the yellowing discoloration of the skin and sclera of a neonate, which is caused by increased levels of bilirubin in the blood. A neonate refers to an infant in the first 28 days of life. [bestpractice.bmj.com]

  Neonatal Jaundice Neonatal jaundice is the yellow discoloration of the skin and eyes due to elevated bilirubin levels in the bloodstream of a newborn. Bilirubin is a byproduct of the breakdown of red blood cells. [embryo.asu.edu]

  In neonates, the yellow discoloration of the skin is first noted in the face and as the bilirubin level rises proceeds caudal to the trunk and then to the extremities. [dbpedia.org]

• Petechiae

  Also, ecchymoses or petechiae (suggestive of hemolytic anemia) are noted. The physical examination should focus on signs of causative disorders. [msdmanuals.com]

  Pallor, petechiae, cephalohaematoma, excessive bruising, hepatoslenomegaly. Hydration and weight status. Plethora (polycythaemia). [kidshealthwa.com]

  Hepatosplenomegaly, petechiae and microcephaly are associated with haemolytic anaemia, sepsis and congenital infections. [patient.info]

• Flushing

  More toxins to flush out which challenges the baby's liver even more!! A lot of this depends upon the TIMING of the jaundice as there is jaundice that is pathological and must be treated more aggressively. [gentlebirth.org]

• Encephalopathy

  Prolonged unconjugated hyperbilirubinemia can result in acute bilirubin encephalopathy and eventually develop into chronic bilirubin encephalopathy (kernicterus). [ncbi.nlm.nih.gov]

  Discuss the major clinical features of acute bilirubin encephalopathy and chronic bilirubin encephalopathy (kernicterus). List the key elements of the American Academy of Pediatrics guidelines for the management of hyperbilirubinemia. [pedsinreview.aappublications.org]

  […] findings of bilirubin encephalopathy. [pediatrics.aappublications.org]

• Seizure

  Kernicterus, in both acute and chronic forms, is manifest by a variety of neurologic and cognitive deficits ranging from poor suckling and seizures to low IQ. Clearly, this disorder should be treated without delay. [vivo.colostate.edu]

  Complications may include seizures, cerebral palsy, or kernicterus.In many cases there is no specific underlying disorder (physiologic). [en.wikipedia.org]

  Advance phase: Pronounced opisthotonus, shrill cry, apnea, seizures, coma and death 2. [epomedicine.com]

  […] pathophysiology (Adaptation (Adaptation to neonatal life ; Thermoregulation) ; Emergency management (Resuscitation of the newborn ; Hypoglycaemia) ; Jaundice (Physiological jaundice ; Pathological jaundice) ; Disorders (Metabolic disorders ; Jitteriness, seizures [ucnstg.dbc.dk]

  The signs of acute bilirubin encephalopathy include: lethargy poor feeding temperature instability hypotonia arching of the head, neck and back (opisthotonos) spasticity seizures. Death may follow. [www2.health.vic.gov.au]

Do workup for underlying cause if receiving phototherapy, appears ill, or bili rising rapidly (i.e. crossing percentiles), and no obvious explanation on Hx/Px: Total and (with the first measurement) direct bilirubin--If the latter is elevated, check u [faculty.washington.edu]

An additional workup for hyperbilirubinemia may include: Blood group and direct Coombs testing in babies who are at risk of Rh or ABO isoimmunization. [pathophys.org]

In up to 50 percent of infants with severe jaundice, breastfeeding and lower gestational age were the only causes identified despite extensive workups. [encyclopedia.com]

• Bilirubin Increased

  If Mother Rh -, Child Rh + Cord Blood Hb Corl Blood Bilirubin > 5 mg % Direct Coomb's +ve This is an Indication for Exchange transfusion. 3. if Bilirubin increase rate > 0.5 mg/dl/hr 4. If Jaundice persists >7days in term >14days in preterm 5. [mediconotebook.com]

  This increase in red blood cell breakdown and decreased ability to metabolize bilirubin overwhelms the newborns ability to properly process and excrete bilirubin. [medicinenet.com]

  Breastfeeding should be increased to every two to two and a half hours. Increased feedings can increase peristalsis and meconium passage, decreasing bilirubin resorption into circulation. [encyclopedia.com]

  Risk Factors A variety of conditions or diseases may present with an increase of the amount of pigment (bilirubin) produced. Poor feeding due to decreased breast feeding or the amount of breast milk can contribute to the increase in bilirubin. [patients.gi.org]

Treatment of neonatal jaundice was the focus of the second study. [acutecaretesting.org]

Phototherapy treatment is the least invasive treatment for neonatal jaundice, but if the infant's bilirubin levels continue to rise even with intensive phototherapy treatment, physicians must perform an exchange transfusion of the infant's blood as soon [embryo.asu.edu]

Treatment depends on cause and degree of bilirubin elevation; the more preterm the infant, the lower the threshold level for treatment. Definitive treatments include phototherapy and exchange transfusion. [msdmanuals.com]

Prognosis depends on timely diagnosis and management. We evaluated the clinical practices among healthcare professionals concerning jaundiced newborns and their ability to recognize pale stools. [ncbi.nlm.nih.gov]

Prevention, and Complications Prognosis ranges widely can spontaneously resolve or be fatal depending on etiology Prevention preventive measures are usually not available stop breast-feeding to speed resolution of neonatal jaundice, though not required [step2.medbullets.com]

Prognosis The prognosis is good, providing there is early recognition. Co-ordination between surgeons and radiotherapists is important. Postoperative aftercare, with adequate long-term monitoring and replacement of hormones, is vital. [patient.info]

Figure 1: Etiologies of neonatal jaundice. [omicsonline.org]

Many different etiologies come into play together, and at times, it is difficult to isolate the cause of neonatal jaundice. [ncbi.nlm.nih.gov]

Abstract Using guidelines of the Meta-analysis of Observational Studies in Epidemiology Group, we systematically reviewed the literature on neonatal jaundice (unconjugated hyperbilirubinemia) and Autism Spectrum Disorder (ASD) in term and preterm infants [ncbi.nlm.nih.gov]

G., In this issue, Paediatric and Perinatal Epidemiology, 20, 4, (269), (2006). [doi.org]

Epidemiology: Up to 60% of term and 80% or prem neonates become clinically jaundiced during the first week of life. Most resolve within 2 weeks and remain well throughout and require no treatment or intervention. [empem.org]

Major pathophysiological causes or associations include ABO and other blood group incompatibility, glucose-6-phoshate-dehydrogenase deficiency, infection and haemolysis of other causes including spherocytosis. [ncbi.nlm.nih.gov]

NEONATAL HYPERBILIRUBINEMIA Pathophysiology Causes of Neonatal Hyperpbilirubinemia Evaluation of Neonatal Jaundice When to Treat How to Treat PATHOPHYSIOLOGY "Bilirubin encephalopathy" Refers to a neonatal syndrome of neurologic abnormalities and, in [faculty.washington.edu]

US Preventive Services Task Force (2009) Screening of infants for hyperbilirubinemia to prevent chronic bilirubin encephalopathy: US Preventive Services Task Force recommendation statement. Pediatrics 124:1172-1173. [omicsonline.org]

Recognition and treatment of Rh hemolytic disease, another known preventable cause of kernicterus, is critical. In addition, effective phototherapy is crucial if we are to make kernicterus a "never-event." [ncbi.nlm.nih.gov]

Screening of infants for hyperbilirubinemia to prevent chronic bilirubin encephalopathy: US Preventive Services Task Force recommendation statement. Pediatrics 2009;124:1172-1177. [karger.com]