Kramer’s scale or transcutaneous bilirubinometry: the ideal choice of a pediatrician? can we trust our eyes?

Background: Neonatal hyperbilirubinemia, though benign in 80% cases, can lead to kernicterus if not diagnosed and treated early. The golden method of estimation is measuring serum bilirubin levels. Both Kramer’s scale and Transcutaneous bilirubinometer are non -invasive methods. Its high time the pediatricians choose an ideal non-invasive and reliable method to detect hyperbilirubinemia. Objective of this study is to find out which has a better correlation with serum bilirubin - transcutaneous bilirubinometer reading (TcB) or Kramer's scale.Methods: The study was conducted in a tertiary newborn center from November 2014 to June 2016. The inclusion criteria included all babies above 34 weeks gestation and exclusion criteria included babies with established direct hyperbilirubinemia, neonatal septicemia, major congenital/ gastrointestinal malformations and those on phototherapy. The sample size was 450 and the correlation was analyzed using ROC curves and plots of agreement was done using Bland Altman charts.Results: The incidence of significant Hyperbilirubinemia is 12%. Transcutaneous bilirubin level had a better correlation and prediction level compared to Kramer at both 24 hours and 48 hours. Bland Altman analysis showed that transcutaneous values were closer to the total serum bilirubin level compared to Kramer values.Conclusion: Transcutaneous bilirubinometry is a better and more ideal choice to replace serum bilirubin levels. In settings where TcB is not feasible, it’s always best to screen for jaundice using Kramer’s scale rather than estimating serum bilirubin values in all babies. In babies where TcB levels are above the cut off range, it’s better to do serum bilirubin levels.

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Non invasive trans-cutaneous bilirubin as a screening test to identify the need for serum bilirubin assessment in healthy term neonates

Journal of Universal College of Medical Sciences ◽

10.3126/jucms.v1i4.9567 ◽

2014 ◽

Vol 1 (4) ◽

pp. 17-21 ◽

Cited By ~ 2

Author(s):

BK Gupta ◽

N Chaudhary ◽

BD Bhatia ◽

Binod Gupta

Keyword(s):

Bilirubin Level ◽

Clinical Assessment ◽

Serum Bilirubin ◽

Serum Bilirubin Level ◽

Total Serum Bilirubin ◽

Total Serum ◽

Trained Observer ◽

Term Neonates ◽

Transcutaneous Bilirubin ◽

Non Invasive

INTRODUCTION: Hyperbilirubinemia is a common problem in the neonates. It can progress to develop kernicterus unless intervention is initiated. Severity of jaundice and decision for management are usually based on total serum bilirubin (TsB) estimation which technique and results closely correlates with total serum bilirubin levels. OBJECTIVES: To compare the accuracy of visual assessment of jaundice by single trained observer based on Kramer's index with total serum bilirubin levels in healthy term neonates. To compare accuracy of non invasive bilirubin assessment with serum bilirubin levels, to compare trans-cutaneous bilirubin assessment on different sites (forehead and sternum) and to develop a cutoff point oftrans-cutaneous bilirubin level for serum bilirubin assessment. METHODS: This prospective study was conducted in the Neonatal unit of the department of Paediatrics at Kasturba Hospital ,Manipal. Study period was from October 2007 to June 2008. Clinical assessment of jaundice was done in healthy term neonates by observer (Trained Paediatric Post Graduate Resident) based on Kramer's index. Transcutaneous bilirubin assessment was done on the forhead and sternum of each baby using JM-103 Minolta. Air shields bilirubino meter. Serum bilirubin level was measured within 30 minutes of the clinical assessment for each baby. RESULTS: This study included 187 healthy term neonates. The mean birth weight was 2856.83gm ± 493.89gm and mean gestation was 38.25+ 1.030 SD. Clinical assessment and Transcutaneous bilirubin(TcB) significantly correlated with total serum bilirubin (TsB), with correlation co-efficient of 0.757 and 0.801 respectively (p 0.0001). Transcutaneous bilirubin assessment over forehead showed a tendency to under estimate total serum bilirubin, with mean difference of-0.31 mg/dl, SD 1.75 mg/dl with 95% confidence interval ofthe mean -0.60 and -0.02 mg/dl (p value 0.05).Transcutaneous bilirubin assessments between 10 mg/dl to 15 mg/dl correlated accurately with total serum bilirubin levels avoiding blood sampling. CONCLUSION: Trained observer clinical assessment of jaundice can be used for screening neonatal jaundice. Non invasive transcutaneous bilirubin assessment has demonstrated significant accuracy with serum bilirubin level estimates between 48 hours to 7 days on two different sites forehead and sternum. DOI: http://dx.doi.org/10.3126/jucms.v1i4.9567 Journal of Universal College of Medical Sciences (2013) Vol.1 No.04: 17-21

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Transcutaneous billirubinometry to estimate total serum bilirubin in neonatal jaundice

Paediatrica Indonesiana ◽

10.14238/pi57.1.2017.8-11 ◽

2017 ◽

Vol 57 (1) ◽

pp. 8 ◽

Cited By ~ 2

Author(s):

Andra Kurnianto ◽

Herman Bermawi ◽

Afifa Darmawanti ◽

Erial Bahar

Keyword(s):

Neonatal Jaundice ◽

Serum Bilirubin ◽

Subcutaneous Tissue ◽

Correlation Coefficients ◽

Total Serum Bilirubin ◽

Blood Sampling ◽

Total Serum ◽

Transcutaneous Bilirubin ◽

Non Invasive ◽

Transcutaneous Bilirubinometry

Background The gold standard for diagnosis of neonatal jaundice is total serum bilirubin (TSB) measurement. This method, however, is invasive, painful, and costly in terms of workload, time, and money. Moreover, repeated blood sampling may lead to significant blood loss, which is of particular concern in preterm infants. To overcome these drawbacks, non-invasive methods of bilirubin measurement have been proposed. Transcutaneous bilirubinometry (TcB) determines the yellowness of the subcutaneous tissue of a newborn infant by measuring the difference between optical densities for light in the blue and green wavelength regions.Objective To evaluate the accuracy of transcutaneous bilirubinometry for estimating TSB levels in neonatal jaundice.Methods Subjects were infants aged < 28 days with jaundice who had never been treated with phototherapy or exchange transfusion. The study was done from February to July 2016 in Mohammad Hoesin Hospital. Subjects underwent transcutaneous bilirubin (TcB) and TSB assays, with a maximum interval of 15 minutes between tests.Results One hundred fifty patients were included in this study. The TcB values > 5 mg/dL were correlated to TSB > 5 mg/dL, with 100% sensitivity and 83.3% specificity. This cut-off point was obtained from a receiver-operator characteristic (ROC) curve with AUC 99.3% (95%CI 97.9 to 100%; P< 0.001).The correlation coefficients (r) for TSB and TcB measurements on the forehead were 0.897 (P<0.001).Conclusion Transcutaneous bilirubinometry can be used to accurately estimate TSB levels in neonatal jaundice, and may be useful in clinical practice as a non-invasive method to reduce blood sampling.

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Transcutaneous bilirubin level to predict hyperbilirubinemia in preterm neonates

F1000Research ◽

10.12688/f1000research.22264.1 ◽

2020 ◽

Vol 9 ◽

pp. 300

Author(s):

Dewi Rahmawati ◽

Mahendra Tri Arif Sampurna ◽

Risa Etika ◽

Martono Tri Utomo ◽

Arend F. Bos

Keyword(s):

Bilirubin Level ◽

Serum Bilirubin ◽

Preterm Neonates ◽

Total Serum ◽

Close Monitoring ◽

Transcutaneous Bilirubin ◽

Group I ◽

Group Ii ◽

Severe Hyperbilirubinemia ◽

Transcutaneous Bilirubinometer

Background: Hyperbilirubinemia is common in neonates, with higher prevalence among preterm neonates, which can lead to severe hyperbilirubinemia. Assessment of total serum bilirubin (TSB) and use of a transcutaneous bilirubinometer (TcB) are existing methods to identify and predict hyperbilirubinemia. This study aimed to determine TcB cut-off values during the first day for preterm neonates to predict hyperbilirubinemia at 48 and 72 hours. Methods: A total of 90 neonates born ≤35 weeks were included in the study. They were divided into two groups (Group I: 1000-1500 grams; Group II: 1501-2000 grams). The bilirubin level was measured on the sternum using TcB at the ages of 12, 24, and 72 h. TSB measurements were taken on the third day or if TcB level reached ± 1.24 mg/dL phototherapy threshold and if TcB showed abnormal results (Group I: 5.76-8.24 mg/dL; Group II: 8.76-11.24 mg/dL). Hyperbilirubinemia was defined as TSB ≥7 mg/dL for group I and >10 mg/dL for group II. Results: In total, 38 group I neonates and 48 group II neonates were observed. Almost half of neonates in group I (44.7%) were suffering from hyperbilirubinemia at the age of 48 hours, with 45.8% of group II at the age of 72 hours. To predict hyperbilirubinemia at the age of 48 hours, the best 24-hour-age TcB cut-off values were calculated to be 4.5 mg/dL for group I and 5.8 mg/dL for group II. To predict hyperbilirubinemia at the age of 72 hours, we determined 24-hour-age TcB value of 5.15 mg/dL for group II. Conclusion: TcB values in the early days of life can be used as hyperbilirubinemia predictors on the following days for preterm neonates. Close monitoring should be managed for those with TcB values higher than the calculated cut-off values.

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Correlation of serum bilirubin and transcutaneous bilirubin in newborns

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20213316 ◽

2021 ◽

Vol 8 (9) ◽

pp. 1547

Author(s):

Pavitra V. Arunachalmath

Keyword(s):

Serum Bilirubin ◽

Tertiary Care ◽

Cross Sectional Study ◽

Total Serum ◽

Care Hospital ◽

Time Data ◽

Cross Sectional ◽

Transcutaneous Bilirubin ◽

Transcutaneous Bilirubinometer ◽

Transcutaneous Bilirubinometry

Background: Hyperbilirubinemia is a very common entity in newborns. Screening all the babies for hyperbilirubinemia is must. Serum bilirubin is the standard method of checking the bilirubin in newborns. This is very cumbersome, invasive and time consuming method. Hence many newborns will be discharged without screening. Transcutaneous bilirubinometry would help us in making this task easy and safe. Hence the present study was planned.Methods: This is an institutional cross sectional study conducted in a tertiary care hospital for a period of 6 months. After a written informed consent from parents/ guardians and considering selection criteria, 500 newborns with clinical jaundice were included in study. Each newborn was examined, transcutaneous bilirubin checked at forehead and sternum and serum bilirubin was done at the same time. Data was statistically analyzed to see the correlation between TcB and TSB.Results: Out of 500 newborns, 316 were males, 184 were females and 475 were term gestation and 25 were preterm. Coefficient of correlation was 0.73 and 0.72 for total serum bilirubin versus forehead and sternum respectively which were statistically significant.Conclusions: Transcutaneous bilirubinometer readings closely correlate with that of serum bilirubin. Hence TcB can be used as a safer, economical and effective tool in screening newborns for hyperbilirubinemia.

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Usefulness of transcutaneous bilirubin assessment measured in non-photo-exposed skin to guide the length of phototherapy: an observational study

Journal of Perinatal Medicine ◽

10.1515/jpm-2018-0429 ◽

2019 ◽

Vol 47 (5) ◽

pp. 568-573 ◽

Cited By ~ 1

Author(s):

Abdón Castro ◽

Carlos Zozaya ◽

Mª Teresa Cuesta ◽

Marina González ◽

Gema Villar ◽

...

Keyword(s):

Serum Bilirubin ◽

Total Serum ◽

Skin Area ◽

Correct Treatment ◽

Transcutaneous Bilirubin ◽

Non Invasive ◽

Exposed Skin ◽

Wide Range ◽

The Difference ◽

Mean Differences

Abstract Background Transcutaneous bilirubinometers are a non-invasive tool to estimate serum bilirubin. However, once on phototherapy (PHT) and after PHT, its usefulness is precluded. The objective of this study was to prove the hypothesis that transcutaneous bilirubin (TcB) assessment in a covered skin area during PHT could be used to guide the duration of PHT in term and moderate-late preterm infants with non-isoimmune hyperbilirubinemia. Methods A small area of parasternal skin was covered before starting on PHT. Total serum and TcB (both in exposed and non-exposed areas) were determined before starting treatment, every 12 h once on PHT and 12 h after its discontinuation. Pearson’s correlation coefficient and paired mean differences between TcB and total serum bilirubin (TSB) were calculated. Bland-Altman plots were obtained. The percentage of correct treatment decisions made based on non-exposed TcB values was calculated. Results During PHT, there was a relatively good correlation between TSB and non-exposed TcB (0.74) estimates, in contrast to exposed TcB estimates (0.52). However, even when comparing non-exposed TcB with TSB, there was a wide range of agreement limits (−3.8 to 4.6 mg/dL). Decisions based on non-exposed TcB values would have been incorrect in 26.6% of the cases. Conclusion Although there is a relatively strong correlation between total serum and TcB in non-PHT-exposed regions, the difference is not narrow enough to be utilized in guiding clinical decisions on the duration of PHT.

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Glucose-6-Phosphate Dehydrogenase (G6PD) Status in Neonatal Jaundice and its Relationship with Severity of Hyperbilirubinemia

Journal of Bangladesh Society of Physiologist ◽

10.3329/jbsp.v4i2.4176 ◽

1970 ◽

Vol 4 (2) ◽

pp. 71-76

Author(s):

Nilufa Akhter ◽

Noorzahan Begum ◽

Waqar Ahmed Khan

Keyword(s):

Bilirubin Level ◽

G6pd Deficiency ◽

Serum Bilirubin ◽

Serum Bilirubin Level ◽

Total Serum ◽

Control Group ◽

Term Neonates ◽

Group A ◽

The Difference ◽

Enzyme Deficient

Background: G6PD deficiency is one of the common inherited enzymatic disorder associated with high incidence of severe neonatal hyperbilirubinemia. Objectives: To observe G6PD status in male, term neonates with jaundice and its correlation with serum level of bilirubin. Methods: This cross sectional study was conducted on 90 male, term neonates with jaundice, age ranged from 3 to 12 days (Group B) in the Department of Physiology, Bangabandhu Sheikh Mujib Medical University (BSMMU) between July 2007 to June 2008. On the basis of total serum bilirubin (TSB) level, study group was further divided into B1(TSB <15mg/dl), B2(TSB 15-20mg/dl) and B3 (TSB>20mg/dl). For comparison age and sex matched 30 apparently healthy neonates (Group A) were also included in the study. Erythrocyte G6PD level was measured by Spectrophotometric method by using kit of Randox. Serum bilirubin level was measured by standard laboratory technique. For statistical analysis ANOVA, independent sample "t" test and Pearson's correlation coefficient test were performed as applicable by using SPSS windows version-12. Results: In this study, erythrocyte G6PD levels were significantly lower in moderate (p<0.01) and severe (p<0.001) hyperbilirubinemic group in comparison to that of control group . However, this enzyme level was lower in mild group compared to that of control but the difference was statistically non significant. Again, this enzyme levels were significantly lower in moderate (p<0.05) and severe (p<0.01) group than that of mild group and also between severe and moderate hyperbilirubinemic group (p<0.05). In this study, G6PD enzyme deficient were found in 1(3.33%) and 6(20%) subjects of group B2 and B3 respectively. Though, percentage of the subjects with enzyme deficiency were higher in severe group ( B3 ) compared to that of moderate group( B2 ) but the difference was statistically not significant. However, no enzyme deficient patient were found in control group (A) and mild hyperbilirubinemic group (B1). Serum bilirubin level showed significant (p<0.05) positive (r=+.429) correlation with erythrocyte G6PD level in control group (A). On the other hand, this level was negatively correlated with G6PD enzyme in groups B1 (r= -.127), B2 (r=-.120) and B3 ( r= -.671) but significant negative correlation in group B3 (p<0.01). Conclusion: The results of the study revealed that severity of hyperbilirubinemia depends on degree of G6PD deficiency. Therefore, early detection of this enzymopathy and close surveillance of the affected neonates may be important in reducing the complications of severe hyperbilirubinemia. Key words: Glucose-6-PD, Hyperbilirubinemia, Neonates DOI: 10.3329/jbsp.v4i2.4176 J Bangladesh Soc Physiol. 2009 Dec;4(2): 71-76

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Effect of Time of Cord Clamping on Serum Bilirubin Level among Full Term Babies Born at Tikur Anbessa Specialized Hospital: A Three Arm Randomized Control Trial.

10.21203/rs.3.rs-237034/v1 ◽

2021 ◽

Author(s):

Biruk Hailu Tesfaye ◽

Mulugeta Betre Gebremariam ◽

Abiy Seifu Estifanos ◽

Asrat D. Gebremedhin

Keyword(s):

Bilirubin Level ◽

Serum Bilirubin ◽

Tertiary Care ◽

Serum Bilirubin Level ◽

Full Term ◽

Total Serum Bilirubin ◽

Total Serum ◽

Care Hospital ◽

Delayed Cord Clamping ◽

Cord Clamping

Abstract Background: Delayed cord clamping (DCC) above one minute is associated with nutritional and developmental benefits newborns. DCC could also lead to elevated serum bilirubin, leading to jaundice that require phototherapy at the early ages of life. However, evidence on the relationship between DCC and outcomes is limited in resource-limited settings.Objective: To evaluate the effect of the time of cord clamping on serum bilirubin level at 24 hours post-birth in an Ethiopian Tertiary Care hospital.Methods: A three-arm, single-blind, randomized controlled trial was conducted between October 2019-January 2020 targeting healthy, full-term neonates. Study participants were randomly assigned into one of the following interventions depending on the timing of cord clamping: immediate cord clamping (<30 seconds), intermediate cord clamping (60 sec), and delayed cord clamping (180 seconds). The primary outcome is serum bilirubin level in the newborns, which was assessed at 24-hour after birth and before they were discharged home. Descriptive analysis was applied to assess differences between groups in terms of demographic, obstetric, and social characteristics of participants, while linear regression model was employed to examine the association between cord clamping time and serum bilirubin level. STATA version 14 was used for statistical analyses.Result: A total of 141 term newborns were included and randomized into the three categories. Demographic, social and obstetrics factors of the women were not different across groups except labor duration that had a P-value < 0.05. Time of cord clamping was not a significant predictor of total serum bilirubin levels at 24 hours post-birth, whereas cord blood total serum bilirubin (coef. 0.24; p<0.05) and bilirubin nomogram high-risk zone (Coef. 6.25; p<0.001) were significant predictors.Conclusion: Time of umbilical cord clamping has no effect on the total serum bilirubin level of neonates at least within 24 hours of birth.

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A Comparison between Transcutaneous and Total Serum Bilirubin in Healthy-term Greek Neonates with Clinical Jaundice

Prague Medical Report ◽

10.14712/23362936.2014.4 ◽

2014 ◽

Vol 115 (1-2) ◽

pp. 33-42 ◽

Cited By ~ 3

Author(s):

Charalambos Neocleous ◽

Alkistis Adramerina ◽

Stefanos Limnaios ◽

Symeon Symeonidis ◽

Chrysoula Spanou ◽

...

Keyword(s):

Serum Bilirubin ◽

Serum Bilirubin Level ◽

Total Serum Bilirubin ◽

Care Plan ◽

Total Serum ◽

Limited Data ◽

Transcutaneous Bilirubin ◽

Appropriate Care ◽

The Mean ◽

Level Of Agreement

The accuracy of transcutaneous bilirubin meters has been assessed in newborns from various ethnic backgrounds. However, there are limited data on Greek newborns. Our study examined the accuracy of transcutaneous bilirubin measurements in clinically jaundiced healthy-term Greek newborns, using total serum bilirubin as the reference standard, in order to re-evaluate our local guidelines about neonatal jaundice. Clinically jaundiced newborns requiring total serum bilirubin level estimation were recruited prospectively. 368 pairs of total serum bilirubin/transcutaneous bilirubin measurements were taken in 222 newborns, using a direct spectrophotometric device and the BiliCheck device, respectively. The level of agreement between the obtained transcutaneous bilirubin and total serum bilirubin values was assessed. Our data were analysed using the Stata/SE 12.0 (StataCorp LP, USA) statistical programme. The mean (± SD) TSB was 225.4 ± 25.4 μmol/l and the mean (± SD) TcB was 237.9 ± 21.0 μmol/l. The correlation between the values was poor (Pearson’s correlation coefficient 0.439; Lin’s concordance coefficient 0.377 [95% CI 0.301 to 0.453]; P<0.001). The Bland-Altman analysis demonstrated that transcutaneous bilirubin measurements tended to overestimate the total serum bilirubin value (mean difference 12.5 ± 24.9 μmol/l), with wide 95% limits of agreement (–36.2 μmol/l to 61.3 μmol/l). Transcutaneous bilirubin values did not correlate well with total serum bilirubin values, being often imprecise in predicting the actual total serum bilirubin levels. This permits us to continue estimating total serum bilirubin in clinically jaundiced newborns according to our local guidelines, in order to safely decide the appropriate care plan.

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Transcutaneous Billirubinometry: A Useful Screening Tool for Neonatal Jaundice in Term and Near Term Babies - A Hospital Based Study

Bangladesh Journal of Child Health ◽

10.3329/bjch.v39i3.31575 ◽

2017 ◽

Vol 39 (3) ◽

pp. 116-122 ◽

Cited By ~ 2

Author(s):

Nargis Ara Begum ◽

Khorshed Alam ◽

Anamika Shaha ◽

Md Sohel Showmik ◽

Runa Laila ◽

...

Keyword(s):

Screening Tool ◽

Serum Bilirubin ◽

Screening Method ◽

Total Serum Bilirubin ◽

Total Serum ◽

P Value ◽

Cross Sectional ◽

Transcutaneous Bilirubin ◽

Severe Hyperbilirubinemia ◽

Transcutaneous Bilirubinometry

Background: Hyperbilirubinemia is a common problem in newborn. Most of the cases are benign but severe hyperbilirubinemia can lead to kernicterus and brain damage which is preventable. The gold standard to asses neonatal hyperbilirubinaemia is serum bilirubin measurement. Unfortunately, this procedure is invasive, painful and time consuming. As the consequence of missing severe hyperbilirubinemia is serious, there is a constant search to find out a safe method to detect jaundice. Transcutaneous bilirubinometry offers objective method of assessing degree of jaundice reducing subjectivity of clinical assessment.Objective: To evaluate the relationship between transcutaneous bilirubin (TcB) and total serum bilirubin (TSB) and assess whether transcutaneous bilirubinometry can be used as a valid screening method for detecting jaundice in term and late preterm babies.Method: A prospective cross-sectional study was performed in well baby nursery of United Hospital Limited, Dhaka from January 2013 to December 2013. Healthy term and late pre term newborn of ?35 wk gestation with clinical evidence of jaundice were included in the study. Total serum bilirubin was measured by Dichlorophenyl Diazonin method and transcutaneous bilirubinometer (JM-103) was used to measure transcutaneous bilirubin (TcB) level.Result: A total of 116 paired samples were analyzed and found strong correlation between TcB and TSB (correlation coefficient 0.8, mean difference 0.83, SD± 1.96 and 95% CI 0.6 to 1.06). Post natal age has significant association with TcB (p value 0.01) and TSB (p value 0.031). Requirement of phototherapy in both group were also significant (p value <0.001). TcB value of 11 mg/dl was chosen as cut off point corresponding TSB level 13 mg/dl with sensitivity 90% and specificity 71%. Above this level indicate need for blood sampling to take appropriate therapeutic measure.Conclusion: Transcutaneous billirubinometry is a non-invasive and valid screening tool for assessing jaundice in newborn.Bangladesh J Child Health 2015; VOL 39 (3) :116-122

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Clinical utility of hand held, non invasive transcutaneous bilirubinometer in neonatal jaundice: a prospective observational study

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20214046 ◽

2021 ◽

Author(s):

Bibhudatta Mishra ◽

Bishwajit Mishra ◽

Guruveera Jeyasingh Malini ◽

Arjit Mohapatra ◽

Prafulla Kumar Biswal ◽

...

Keyword(s):

Clinical Utility ◽

Neonatal Jaundice ◽

Prospective Observational Study ◽

Screening Tool ◽

Serum Bilirubin ◽

Blood Sampling ◽

Viable Option ◽

Transcutaneous Bilirubin ◽

Non Invasive ◽

Transcutaneous Bilirubinometer

Background: Neonatal Jaundice is the most common morbidity in the first week of life, occurring in 60% of term and 80% of preterm newborn. However, visual inspection, being subjective, usually inaccurate and unreliable and will result in a number of unnecessary blood sampling. Taking all these in to considerations, transcutaneous bilirubinometer (TCB) may provide a solution which is an objective, noninvasive, fast and painless method of bilirubin estimation.Methods: Transcutaneous bilirubinometer levels were measured at forehead and sternum and blood samples for TSB were collected by venepuncture within 30 minutes and sent to biochemistry lab. After getting serum bilirubin reports, TCB and TSB values were compared by using Bhutani’s hour specific nomogram. Results: The correlation between serum bilirubin and transcutaneous bilirubin measured at forehead and sternum is very good at serum bilirubin <15 mg/dl, r value (Karl Pearson’s Correlation co-efficient) is 0.93 and 0.94 respectively.Conclusions: The findings of the present study indicate that the TCB is a reliable screening tool for hyperbilirubinemia in newborns >35 weeks of gestation, especially with bilirubin levels ≤15 mg/dl in 2-7 days of life. TCB can be a viable option for universal screening. Incorporating the use of TCB devices in clinical practice, can reduce the need for blood sampling for the management of neonatal jaundice.

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