scholarly journals Clinical profile and aetiological factors of neonatal jaundice from a rural area of Kutch, Gujarat, India

2020 ◽  
Vol 8 (1) ◽  
pp. 143
Author(s):  
Avinash Patel ◽  
Karan Saradava ◽  
Hasmukh Chauhan
Keyword(s):  
Birth Weight ◽  
Neonatal Intensive Care ◽  
Neonatal Jaundice ◽  
Prospective Observational Study ◽  
Medical Science ◽  
Clinical Profile ◽  
Rural Setting ◽  
Abo Incompatibility ◽  
Rh Incompatibility ◽  
Blood Grouping

Background: Etiology of hyperbilirubinemia is not only crucial for optimal management of the patient but also it may have implications for subsequent pregnancies. The objective of this study was to study the clinical profile and the underlying aetiological factors leading to neonatal jaundice in this rural setting of Kutch District, Gujarat, India.Methods: This prospective observational study was conducted in the neonatal intensive care unit (NICU) and Post Natal ward Gujarat Adani Institute of Medical Science, Bhuj, Kutch, Gujarat. Total of 150 cases were enrolled for the study. Blood grouping and Rh typing of baby and mother were done. Cord blood bilirubin and haemoglobin, direct coomb's test (DCT) and bilirubin monitoring were done whenever there was a setting for Rh incompatibility.Results: Among 150 neonates studied, majority had birth weight between 2501g and 3000g. Only 21 babies had birth weight <2.5kg (14%) (Table 2). Of the 150 neonates 85 were males and 65 were females.Conclusions: This study concludes that physiological jaundice is the most common cause of neonatal jaundice in our hospital. This is followed by ABO incompatibility, sepsis, Rh incompatibility and idiopathic cases.

scholarly journals Neonates with Jaundice A Clinical Profile

2020 ◽  
Vol 8 (1) ◽  
pp. 21-23
Author(s):  
Davis Manuel ◽  
Shajahan R A
Keyword(s):  
Breast Feeding ◽  
Neonatal Intensive Care ◽  
Neonatal Jaundice ◽  
Prospective Observational Study ◽  
Clinical Profile ◽  
Abo Incompatibility ◽  
Common Causes ◽  
Rh Incompatibility ◽  
Preterm Babies ◽  
Haemolytic Anemia

Background: In the first week of child birth, neonatal jaundice is the most common problem which leads to delayed hospital discharge and re-admissions. Recognising early neonatal hyperbilirubenemia plays a pivotal role in preventing serious complications. The aim of this study was to study the clinical profile and the aetiological factors leading to neonatal jaundice in rural areas.Subject and Method:This study is a prospective observational study  conducted in neonatal intensive care unit (NICU) and post natal ward . This study was conducted during the period of February 2017 to July 2017. Total 400 neonates were admitted in NICU and post natal ward during this period. Out of them, 100 newborns were having jaundice (Serum bilirubin > 10 mg/dl). 100 cases in total were enrolled in the study. Result:In this study,out of 100 neonates, 70% were males and 30% were females. , 92 were born at term (92%) and remaining 10 were preterm babies (10%). Physiological jaundice constituted 45%, followed by ABO incompatibility constituted 25%, followed by sepsis(1%), Rh incompatibility (8%), idioapathy (8%), prematurity (5%), cephalhematoma (4%), breast feeding (2%), haemolytic anemia (2%) were diagnosed as hereditary spherocytosis. Conclusion:Physiological jaundice is the most common cause of neonatal jaundice followed by ABO incompatibility, sepsis, Rh incompatibility and idiopathic cases. Cephalhematoma, breast feeding jaundice and haemolytic anaemia are the less common causes. Hence, it is required to monitor neonates more appropriately and accurately.

scholarly journals Risk Factors and Causes of Neonatal Hyperbilirubinemia: A Systematic Review Study

2020 ◽  
Vol 8 (4) ◽  
pp. 211-222
Author(s):  
Hassan Boskabadi ◽  
◽  
Forough Rakhshanizadeh ◽  
Ali Moradi ◽  
Maryam Zakerihamidi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Birth Weight ◽  
G6pd Deficiency ◽  
Neonatal Jaundice ◽  
Diabetic Mother ◽  
Neonatal Hyperbilirubinemia ◽  
Abo Incompatibility ◽  
Rh Incompatibility ◽  
Review Study

Context: Jaundice is a common problem and the most common risk factor for hospitalization during the neonatal period.      Objective: The prevention of neonatal hyperbilirubinemia would not be possible without identifying its predisposing risk factors. The present systematic review study aims to determine the risk factors of neonatal jaundice. Data Sources: Databases including Science Direct, Cochrane Library, Web of Science (ISI), PubMed, and Google Scholar were searched to identify all eligible papers concerning the risk factors of neonatal hyperbilirubinemia.  Study Selection: This systematic review was performed to review the causes and risk factors of neonatal hyperbilirubinemia. Finally, 18 articles were defined as eligible for further review. Data Extraction: The keywords included neonates, jaundice, hyperbilirubinemia, and risk factors. The inclusion criteria were studies determining jaundice risk factors, while papers with only published abstracts were excluded. Results: A total of 18 eligible articles (3 retrospective, 4 prospective, 10 cross-sectional, and 1 historical cohort) out of 421 retrieved articles were included in this review. The etiologic causes for neonatal jaundice were ABO incompatibility (24.6%), infection (including UTI and sepsis) (13.7%), G6PD deficiency (9.4%), Rh incompatibility (7%), and cephalohematoma (2.9%), while, known predisposing factors for neonatal jaundice included unknown (33.2%), low birth weight (30.9%), hyperbilirubinemia in siblings (22.7%), prematurity (20.1%), and infant of diabetic mother (6.7%). Conclusion: According to our review with considering the studies, the etiologic causes for neonatal jaundice are ABO incompatibility, infection (including UTI and sepsis), G6PD deficiency, Rh incompatibility, and cephalohematoma. While, known predisposing factors for neonatal jaundice include low birth weight, hyperbilirubinemia in siblings, prematurity, and infant of diabetic mother.

scholarly journals Clinical profile of pathological Jaundice among neonates admitted in the National Referral Hospital, Bhutan

2021 ◽  
Vol 7 (2) ◽  
pp. 13-18
Author(s):  
Kinzang Dechen ◽  
Tenzin Lhadon ◽  
Mimi Lhamu Mynak ◽  
Phurpa Phurpa
Keyword(s):  
Weight Loss ◽  
Neonatal Intensive Care ◽  
Neonatal Jaundice ◽  
Referral Hospital ◽  
Clinical Profile ◽  
Excessive Weight Loss ◽  
Cross Sectional ◽  
Abo Incompatibility ◽  
Excessive Weight ◽  
National Referral Hospital

Background: Neonatal jaundice is a common condition especially in the first week of life. There are various maternal and neonatal clinical characteristics that have been associated with pathological jaundice. Objectives: To describe clinical profile of pathological jaundice and to estimate its prevalence among newborns admitted at the National Referral Hospital. Methods: A cross-sectional descriptive study design was used to study pathological jaundice cases admitted at the Gyaltsuen Jetsun Pema Neonatal Intensive Care Unit (NICU) of Jigme Dorji Wangchuck National Referral Hospital (JDWNRH) from 7th November 2018 till 6th November 2019. Data was collected using a predesigned case proforma, entered and analyzed in Epidata after obtaining ethical clearance from the Research Ethics Board of Health (REBH), Bhutan.  Results: Facility based prevalence rate of pathological neonatal jaundice was found to be 63.66% in our setting. The median age on presentation was 4 days. Blood group ABO incompatibility and neonates less than one week of age were found to be most common neonatal profile in this study. Significant association was found between primiparous mothers and excessive weight loss. Conclusion: The prevalence of pathological jaundice was high in our setting. ABO incompatibility, neonates less than one week of age, primigravida mothers with feeding issues should be closely followed or screened for pathological jaundice especially during the first one week of life. Keywords: Pathological jaundice, Prevalence, ABO incompatibility, feeding issues, excessive weight loss

scholarly journals Study of clinical spectrum of hyperbilirubinemia with frequency of glucose six phosphate dehydrogenase deficiency in neonates

2021 ◽  
Vol 9 (6) ◽  
pp. 1674
Author(s):  
Keshawati Goel ◽  
Anshuman Srivastava
Keyword(s):  
G6pd Deficiency ◽  
Prospective Observational Study ◽  
Dehydrogenase Deficiency ◽  
Uttar Pradesh ◽  
Neurological Deficits ◽  
Medical College ◽  
Abo Incompatibility ◽  
Mucous Membranes ◽  
Rh Incompatibility ◽  
Breast Fed

Background: Jaundice is defined as visible reflexion of serum hyperbilirubinemia on mucous membranes and skin as yellowish discoloration. The frequency of icterus among neonates is about 1 in 2500-5000 live births. When there is disparity between the production of bilirubin, conversion from unconjugated to conjugated bilirubin and excretion of bilirubin results in jaundice. Unconjugated bilirubin is usually harmless but it can also cross blood-brain barrier causing neurotoxicity or kernicterus.Methods: A hospital based prospective observational study which is carried out in the department of paediatrics of Teerthanker Mahaveer Medical College, Moradabad, Uttar Pradesh from December 2019 to November 2020 on 74 neonates who required admission for hyperbilirubinemia.Results: The most common jaundice occurred in neonates were idiopathic or breastfeeding jaundice as the neonates were breast fed (47.29%). The second most common cause was ABO incompatibility leading to jaundice in 27 (36.48%) neonates. Incidence of neonatal Sepsis, G6PD deficiency, hypothyroidism and cephalhematoma was 22.9%, 4.1%, 2.70% and 4.1% respectively. Polycythemia contributed to 1.35% and the frequency of hyperbilirubinemia in infants of diabetic mother’s or GDM was 10.8%. Rh incompatibility was seen in 13.5%.Conclusions: G6PD deficiency is a significant cause for NNHB and the cases with pathological jaundice if left untreated may lead to severe neurological deficits and lifelong disabilities, hearing impairment, mental retardation, seizures and movement disorders. Hence we recommend G6PD screening in every newborn with significant hyperbilirubinemia to reduce morbidity and mortality.

scholarly journals Association of ABO and Rh incompatibility with neonatal hyperbilirubinaemia

2017 ◽  
Vol 6 (4) ◽  
pp. 1368 ◽  
Author(s):  
Apexa S. Patel ◽  
Deepak A. Desai ◽  
Aneri R. Patel
Keyword(s):  
Prospective Observational Study ◽  
Proper Time ◽  
Treated Group ◽  
Incompatibility Group ◽  
Haemolytic Disease ◽  
New Born ◽  
Physiological Limits ◽  
Abo Incompatibility ◽  
Rh Incompatibility ◽  
Clinically Significant

Background: 60% of term new-born have clinical jaundice, in the first week of life. ABO incompatibility is the most common cause of haemolytic disease of the new-born. So early intervention, at proper time, is mandatory to prevent these sequelae.Methods: This study was done at Dhiraj Hospital in Obstetrics and Gynecology Department. It was prospective observational study. 200 new-born with ABO incompatibility and 20 new-born with Rh incompatibility, causing clinically significant neonatal hyperbilirubinemia, were recruited for the clinical study noted.Results: The incidence of ABO incompatibility in our study was 13.79% and of Rh incompatibility was 1.37%. In ABO incompatibility group, 90% new born developed clinical jaundice. In treated group, out of 88 new born, 82 were from O-A and O-B incompatibility group. In ABO incompatibility DCT was positive in only 9%, whereas in Rh incompatibility it was 25%. In ABO incompatibility group, majority, 56% did not require treatment, whereas in Rh incompatibility group 65% required treatment. In ABO incompatibility group only 1% required exchange transfusion whereas in Rh incompatibility, it was required in 10%. In ABO incompatibility, all new-born treated well except, 0.5% developed kernicterus. In Rh incompatibility group, 10% new-born developed kernicterusConclusions: In ABO incompatibility, if jaundice develops, it remains in physiological limits. In presence of some aggravating conditions may present as pathological jaundice. It results in significant morbidity but no mortality. So prevention of aggravating factors is very important, in case of ABO incompatibility. 

scholarly journals Conservative Management of Pneumoperitoneum in Necrotising Enterocolitis- Is it Possible?

2016 ◽  
Vol 5 (2) ◽  
pp. 12
Author(s):  
Anand Pandey ◽  
Shailendra P Singh ◽  
Vipin Gupta ◽  
Rajesh Verma
Keyword(s):  
Intensive Care Unit ◽  
Severe Sepsis ◽  
Intensive Care ◽  
Birth Weight ◽  
Neonatal Intensive Care ◽  
Prospective Observational Study ◽  
Necrotising Enterocolitis ◽  
Viable Option ◽  
The Mean

Introduction: Necrotizing enterocolitis (NEC) is a common in neonatal intensive care unit (NICU) patients; especially in premature and low birth weight ones. Surgery is indicated when there is pneumoperitoneum. Other therapies include conservative observation or primary peritoneal drain (PPD). This study was conceived to evaluate peritoneal tapping, rather than primary peritoneal drain (PPD) as a treatment of NEC.Material and Methods- This prospective observational study conducted from December 2012 to December 2014 and including all patients of NEC having pneumoperitoneum on X-ray.Results- There were 12 patients of NEC. Seven patients responded to single peritoneal tapping. Three patients needed one more tapping. Laparotomy was required in remaining two patients. One patient, who underwent laparotomy, expired due to severe sepsis. The mean duration of follow up was 4.83 months (range 2 to 8).Conclusion- Peritoneal tapping in NEC who develops pneumoperitoneum appears to be a viable option. Further studies in this regard may substantiate this mode of therapy.

Effectiveness of two probiotics in preventing necrotising enterocolitis in a cohort of very-low-birth-weight premature new-borns

2021 ◽  
pp. 1-8
Author(s):  
J. Uberos ◽  
A. Campos-Martinez ◽  
E. Fernandez-Marín ◽  
I. Cubero Millan ◽  
A. Ruiz Lopez ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Lactobacillus Acidophilus ◽  
Neonatal Intensive Care ◽  
Prospective Observational Study ◽  
Very Low Birth Weight ◽  
Bifidobacterium Bifidum ◽  
Necrotising Enterocolitis ◽  
Probiotic Supplementation ◽  
Different Strains

According to previous research, the incidence of necrotising enterocolitis (NEC) decreases after supplementation with probiotics. However, few studies have considered the equivalence or otherwise of different strains of probiotics in this respect. Accordingly, this prospective observational study was conducted in a cohort of 245 very-low-birth-weight (VLBW) new-borns to assess the prevalence of NEC after supplementation with the probiotic Inforan® (Berna Biotech, Madrid, Spain) 250 mg capsules containing 109 cfu of Lactobacillus acidophilus (ATCC 4356) and 109 cfu of Bifidobacterium bifidum (ATCC 15696); or with Bivos® (Ferring, Madrid, Spain) containing Lacticaseibacillus (formerly Lactobacillus) rhamnnosus (LGG) (ATCC 53103) (109 cfu); or with no probiotic supplementation. Statistical analysis was performed using multivariant regression for the duration of parenteral nutrition, length of neonatal intensive care unit stay, use of oxygen therapy and presence of chorioamnionitis. Of the VLBW new-borns in the study group, 65 received Infloran, 108 received Bivos and 72 received no probiotic. A significant association was observed between a reduced presence of NEC Stage ≥2 and probiotic supplementation. The odds risk (OR) obtained was 0.174 (95% confidence interval (CI): 0.032-0.936) for Infloran and 0.196 (95%CI: 0.053-0.732) for Bivos. Therefore, both probiotics are associated with a lower prevalence of NEC in VLBW new-borns, with no significant differences.

Phototherapy for Hyperbilirubinemia of Hemolytic Disease of the Newborn

PEDIATRICS ◽  
1985 ◽  
Vol 75 (2) ◽  
pp. 407-441
Author(s):  
Harold M. Maurer ◽  
Barry V. Kirkpatrick ◽  
Nancy B. McWilliams ◽  
David A. Draper ◽  
Dolores A. Bryla
Keyword(s):  
Birth Weight ◽  
Serum Bilirubin ◽  
Hemolytic Disease ◽  
Bilirubin Concentration ◽  
Term Infants ◽  
Abo Incompatibility ◽  
Rh Incompatibility ◽  
Infant Birth ◽  
Positive Results ◽  
Serum Bilirubin Concentration

Although phototherapy has proven effective in lowering the serum bilirubin concentration of fullterm and premature infants with physiologic or idiopathic hyperbilirubinemia, its effect on serum bilirubin concentration in hemolytic disease due to ABO blood group incompatibility remains uncertain. Sisson and associates91 have reported a marked effect of phototherapy on serum bilirubin levels and exchange transfusion rates in premature and full-term infants with ABO incompatibility. Others have reported similar findings, but studies were retrospective49 or uncontrolled.80 On the other hand, Patel and associates79 found no significant clinical response to phototherapy in five infants (four with birth weight &gt;2,500 g) with ABO and one infant (birth weight 2,660 g) with Rh incompatibility. A total of 1,339 infants were randomly selected for study between May 1974 and June 1976. Of the 1,339 infants, 79.4% weighed less than 2,500 g and 276 (20.6%) were 2,500 g or more at birth. Of the 1,063 infants who weighed less than 2,500 g, 17 had positive findings on Coombs tests, 14 due to ABO incompatibility and three due to Rh incompatibility. As phototherapy was administered early and prophylactically in infants weighing less than 2,000 g and late and therapeutically in infants weighing between 2,000 and 2,499 g, a combined analysis of the infants weighing less than 2,500 g and who had positive results on Coombs test was not possible. Of the 276 infants whose birth weight was 2,500 g or more, 64 (23.1%) had positive findings on Coombs tests, 58 due to ABO incompatibility and six to Rh incompatibility.

scholarly journals Single-centre prospective observational study on postdelivery room care

2020 ◽  
Vol 4 (1) ◽  
pp. e000602
Author(s):  
Frederike Vivien Hartmann ◽  
Gerd Bauerschmitz ◽  
Helmut Küster
Keyword(s):  
Birth Weight ◽  
Observational Study ◽  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
Prospective Observational Study ◽  
Total Duration ◽  
Extremely Low Birth Weight ◽  
Single Centre ◽  
Term Outcome ◽  
Long Term Outcome

ObjectivesAs quality of care in the delivery room has major impact on outcome of preterm infants, multiple guidelines have been established in recent years. There is, however, little evidence on how to proceed during postdelivery room care, the time of transfer and admission to the neonatal intensive care unit (NICU). The aim of this study was to identify processes taking place during this period with potential impact on outcome.Study designProspective observational study.SettingSingle-centre German tertiary NICU.Patients40 inborn preterm infants undergoing postdelivery room care.Main outcomePrevalence of prolonged duration of postdelivery room care, disconnections from the ventilator and positioning of preterm infants.ResultsTotal duration of postdelivery room care and NICU admission procedures were shorter in infants transferred in a transport incubator compared with using a NICU care station from birth. Extremely low birth weight (ELBW) infants spend 8% of the time in prone position in contrast to 39% in non-ELBW. Total duration of disconnection from the ventilator was 50 s and was ten times longer in infants who had nasal CPAP compared with infants intratracheally intubated. Infants with nCPAP had longer duration of disconnection from the ventilator if body weight was >1000 g or if they were transferred in a transport incubator.ConclusionsMultiple parameters like birth weight or type of transport affect neonatal care during the postdelivery room period. Prospective studies are needed to identify and optimise parameters within this period that affect long-term outcome.

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