Definition
What is Icterus
Yellow coloring
What are the causes of neonatal jaundice in a baby under 24 hours of age?
ALWAYS PATHOLOGIC
Hemolytic - ABO or Rh incompatibility
Sepsis - GBS, congenital infection (TORCH)
Increases the severity/duration of jaundice?
prematurity
• acidosis
• hypoalbuminemia
• dehydration
What areas of a neonate should be examined for signs of jaundice
look at sclera, mucous membranes, palmar creases, tip of nose, frenulum
What is kernicterus
Kernicterus is a type of brain damage that can result from high levels of bilirubin in a baby's blood.
What is the difference between pathological jaundice and physiological jaundice
Pathologic jaundice appears at birth or within 24 hours of life whereas physiologic jaundice will appear after the first 24 hours
Maternal risk factors for physiologic jaundice?
Ethnic group (e.g. Asian, native American)
Complications during pregnancy (infant of
diabetic mother, Rh or ABO incompatibility)
Breastfeeding
What labs tests should be ordered in the evaluation of jaundice?
Total & direct bilirubin
- CBC
- Direct Coombs Test
- Blood group & type
- reticulocyte count
- G6PD
- sepsis evaluation for TORCH.
What is Physiologic jaundice
Physiological jaundice is harmless and occurs in most infants between the third and the eighth day of life.
Jaundice that occurs in the first days of life of breastfed newborns due to inadequate fluid intake and dehydration
Breast feeding Jaundice
Perinatal risk factors for physiologic jaundice?
Birth trauma (cephalohematoma, ecchymoses)
Prematurity
Does kernicterus result from unconjugated or conjugated bilirubin deposits
Unconjugated! It’s not water soluble, its fat soluble so it gets deposited in the brain.
What is Pathologic jaundice
Pathologic Jaundice is considered pathologic if it presents within the first 24 hours after birth, the total serum bilirubin level rises by more than 5 mg per dL (86 mol per L) per day or is higher than 17 mg per dL (290 mol per L), or an infant has signs and symptoms suggestive of serious illness.
What are the causes of neonatal jaundice in babies 24-72 hours old?
Physiologic, polycythemia Dehydration (breastfeeding jaundice) Hemolysis (G6PD deficiency, pyruvate kinase deficiency, spherocytosis, bruising, hemorrhage, hematoma) Sepsis/congenital infection
What family and maternal history is important in the evaluation of jaundice in a neonate?
Family hx of anemia or jaundice
- Maternal O blood type or Rh negative
- Maternal drug intake (sulfa)
- infections during pregnancy
- early term
- blood loss during delivery, delayed clamping of cord, infection, or drugs (sulfas) during delivery
What do we call the treatment that involves replacing the baby’s blood with a donor blood in order to decrease the bilirubin level?
Exchange Transfusion
Who is at risk of getting jaundice
Any baby can get Jaundice, but it has been found that the incidence of neonatal jaundice is increased in infants of East Asian, American Indian, and Greek descent
bilirubin >17
Pathological Jaundice
how many slides did we have
25
T/F Physiological jaundice does not require treatment
False