scholarly journals 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.

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 for 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 a 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 does not affect the total serum bilirubin level of neonates at least within 24 hours of birth.

scholarly journals 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.

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.

scholarly journals Cord Serum Bilirubin Level in Predicting the Development of Significant Hyperbilirubinemia in Newborns with ABO Incompatibility

2016 ◽  
Vol 35 (3) ◽  
pp. 231-236
Author(s):  
Sunita Arora ◽  
Shifali
Keyword(s):  
Blood Group ◽  
Bilirubin Level ◽  
Serum Bilirubin ◽  
Tertiary Care ◽  
Serum Bilirubin Level ◽  
Total Serum ◽  
Care Hospital ◽  
Hemolytic Disease ◽  
Cord Serum ◽  
Abo Incompatibility

Introduction: Neonatal hyperbilirubinaemia is common problem which is benign in majority of neonates. Rh iso immune hemolytic disease as a cause of hyperbilirubinemia is becoming nearly nonexistent due to the use of prophylactic anti D. Hence Isoimmune hemolytic disease due to ABO incompatibility assumes significance as a cause of significant hyperbilirubinaemia. This study was conducted to determine the incidence of ABO incompatibility, ABO iso immune disease in new born, to determine critical cord serum bilirubin level to predict subsequent significant hyperbilirubinemia.Material and Methods: The study was done in neonatal ICU of a tertiary care hospital where 100 full term healthy newborns with B.W≥2500gm and gestational age ≥37 wk with blood group A, B, AB, born to mothers with O blood group without simultaneous Rh incompatibility at SGRDIMSR were included. Serum bilirubin was measured approximately at 12-24hrs, 36-48hrs, 60-72hrs. Results: Out 100 ABO incompatible newborns 33(33%) developed ABO isoimmune disease manifesting as significant hyperbilirubinaemia with any of the four total serum bilirubin levels exceeding threshold levels defined for phototherapy. TSB of ≥ 2.16mg/d1 from cord blood has a sensitivity of 100% specificity of 89.55%, NPV 100% and PPV of 82.50% to predict significant hyperbilirubinaemia. Conclusion: A critical cord S.bilirubin between 2.16 mg/d1 and 4.09mg/d1 will predict all newborns who will have significant hyperbilirubinaemia and can be used as a safe demarcator to decide time of discharge. Any therapeutic intervention if necessary can be started as early as possible.J Nepal Paediatr Soc 2015; 35(3): 231-236 

scholarly journals The value of transcutaneous method of bilirubin measurement in newborn population with the risk of ABO hemolytic disease

Medicina ◽  
2009 ◽  
Vol 45 (10) ◽  
pp. 792 ◽  
Author(s):  
Dalia Stonienė ◽  
Jūratė Buinauskienė ◽  
Eglė Markūnienė
Keyword(s):  
Bilirubin Level ◽  
Predictive Value ◽  
Serum Bilirubin ◽  
Newborn Infants ◽  
Serum Bilirubin Level ◽  
Total Serum Bilirubin ◽  
Total Serum ◽  
Hemolytic Disease ◽  
Significant Difference ◽  
Abo Hemolytic Disease

Objective of the study. To evaluate the correlation between total serum bilirubin (TSB) and transcutaneous bilirubin (TcB) levels in newborn infants at risk of ABO hemolytic disease. Material and methods. During a prospective study, 130 full-term (≥37 weeks of gestation) newborn infants with diagnosed ABO blood group incompatibility were examined. TSB level was measured at the age of 6 hours; further measurements were performed at 24, 48, and 72 hours following the first measurement. Blood samples were collected from the peripheral veins. In clinical laboratory, total serum bilirubin level was measured using Jendrassik-Grof method. TcB level in the forehead was measured using a noninvasive bilirubinometer BiliCheck (SpectRX Inc, Norcross, GA) according to the manufacturer’s instructions within ±30 min after getting a blood sample. Results. During the study, 387 double tests were performed to measure TSB and TcB levels. TSB level (114.83 [62.85] μmol/L) closely correlated with TcB level (111.51 [61.31] μmol/L) (r=0.92, P<0.001). The strongest correlation was reported at the age of 54 hours (r=0.873, P<0.001), the weakest – at the age of 6 hours (r=0.729, P<0.001). TSB and TcB levels showed a strong correlation; the difference between these values was significant (95% CI, 0.70; 5.93; P<0.05). The greatest difference between TSB and TcB levels was detected at the age of 6 hours (5.58 [17.46] μmol/L, 95% CI, 2.55; 8.61; P<0.001). No significant difference was reported at the age of 30, 54, and 78 hours. Using linear regression analysis, it was established that correlation of TSB and TcB was described by equation y=14.13+0.903x. Transcutaneously measured bilirubin level underestimated serum bilirubin level. When at the age of 6 hours TcB level is ≥98 μmol/L, ABO hemolytic disease in newborns may be diagnosed with 100% sensitivity and 98% specificity; positive predictive value was 62% and negative predictive value was 100%. While a newborn’s age increases, TcB sensitivity and specificity for diagnosing ABO hemolytic disease decrease. Conclusion. While evaluating bilirubin level transcutaneously according to nomograms of serum bilirubin level, the results should be considered with caution, especially for newborns with a risk of ABO hemolytic disease. The hour-specific nomograms of transcutaneous

scholarly journals Comparison of Serum Bilirubin Level of Neonates Under Phototherapy with Two Methods of Transcutaneous and Total Serum Bilirubin Measurement

2020 ◽  
Vol 11 (2) ◽  
Author(s):  
Alireza Sadeghnia ◽  
Nasrin Hashemian Nejad ◽  
Shadi Noorizadeh ◽  
Ehsan Shahrestanaki ◽  
Zahra Jamshidi ◽  
...  
Keyword(s):  
Bilirubin Level ◽  
Serum Bilirubin ◽  
Serum Bilirubin Level ◽  
Total Serum Bilirubin ◽  
Total Serum

scholarly journals Effect of Oral Fenofibrate on Serum Bilirubin Level in Term Neonates with Unconjugated Hyperbilirubinaemia: A Randomized Control Trial

2021 ◽  
Vol 16 (1) ◽  
pp. 35-38
Author(s):  
Murshida Mosharref ◽  
Naila Rehnuma ◽  
Nusrat Jahan ◽  
Farzana Zafreen
Keyword(s):  
Bilirubin Level ◽  
Serum Bilirubin ◽  
Serum Bilirubin Level ◽  
Total Serum Bilirubin ◽  
Military Hospital ◽  
Total Serum ◽  
Control Group ◽  
Term Neonates ◽  
Normal Birth ◽  
And Control

Introduction: Hyperbilirubinemia is a common problem in the neonatal period. Phototherapy is the most important proposed treatments for hyperbilirubinemia, but several drugs along with phototherapy are used with recent advances. Aim: To see the effect of oral fenofibrate on serum bilirubin level in term neonates with unconjugated hyperbilirubinaemia. Methods: This prospective study was carried out in Combined Military Hospital Cumilla from July 2018 to June 2019. Total 60 term and normal birth weight neonates with neonatal jaundice were enrolled in this study. Jaundiced newborns presenting with infection, G6PD deficiency, conjugated bilirubin >2 mg/dl or >15% of total serum bilirubin (TSB) and congenital anomalies were excluded from this study. These neonates were randomly allocated to the Fenofibrate group (30 cases) and Control group (30 cases). Total serum bilirubin was measured every 24 hours till the end of phototherapy and at the time of discharge. Statistical analysis was done using SPSS 22.0 and p<0.05 was considered significant. Results: There were no significant differences in gender, age, weight, gestational age and type of delivery between two groups. Mean duration of hospital stay were 4.0±0.7 and 5.5±1.4 days in Fenofibrate group and Control group respectively (p<0.001). In Fenofibrate group, TSB was decreased from 17.2 mg/dl to 15.2 mg/dl after 24 hours, to 13.6 mg/dl after 48 hours, and to 10.1 mg/dl at the time of discharge.  In control group, TSB was decreased from 17.0 mg/dl to 16.3 mg/dl after 24 hours, to 15.9 mg/dl after 48 hours, and to 10.3 mg/dl at the time of discharge. Conclusion: Treatment of neonatal unconjugated hyper- bilirubinemia with fenofibrate reduces neonatal bilirubin levels and decreases the need for phototherapy and hospitalization. JAFMC Bangladesh. Vol 15, No 1 (June) 2020: 35-38

scholarly journals Efficacy of Transcutaneous Bilirubinometry as Compared to Serum Bilirubin in Preterm Newborn During Phototherapy

2021 ◽  
Author(s):  
Sunil Gothwal ◽  
Neelam Singh ◽  
Sadasivam Sitaraman ◽  
Ramesh Choudhary ◽  
Kailash Kumar Meena ◽  
...  
Keyword(s):  
Neonatal Intensive Care ◽  
Serum Bilirubin ◽  
Tertiary Care ◽  
Total Serum Bilirubin ◽  
Preterm Neonates ◽  
Total Serum ◽  
Skin Area ◽  
Care Hospital ◽  
Transcutaneous Bilirubin ◽  
The Difference

Abstract Transcutaneous measurement of bilirubin is being used for neonatal jaundice. Its utility during phototherapy in preterm babies is not established. Objective of our study was to assess the efficacy of transcutaneous bilirubin (TcB) measurement in comparison to total serum bilirubin in preterm newborns at admission and during phototherapy at covered skin area (glabella). It was a prospective observational study and conducted at neonatal intensive care unit of a tertiary care hospital from January 2017 to January 2019. One hundred eligible preterm neonates were enrolled. Babies who were very sick, with poor peripheral circulation, edematous, having conjugated hyperbilirubinemia, with major congenital malformations, already received phototherapy or exchange transfusion were excluded. Paired total serum bilirubin and transcutaneous bilirubin were measured at admission, at 6 hours and 24 hours during phototherapy. TcB was measured from area (glabella) covered by eye protector during phototherapy. Sample for TsB was taken within 10 minutes of TcB measurement. The mean difference between TsB and TcB values at admission, 6 hours and 24 hours of phototherapy were -0.005 (0.353), --0.350 (0.611), and -0.592 (0.353) respectively. At admission or before starting of phototherapy the difference (TsB-TcB) was statistically not significant (p=.125), while the difference in these values were statistically significant at 6 hours and 24 hours of phototherapy. Conclusion: TcB measurements from covered skin area in jaundiced preterm infants during phototherapy were not correlated with TsB and cannot be used as an alternate of serum bilirubin levels.

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

2014 ◽  
Vol 1 (4) ◽  
pp. 17-21 ◽  
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

scholarly journals Hyperbilirubinemia and appendicular perforation peritonitis

2020 ◽  
Vol 7 (3) ◽  
pp. 834
Author(s):  
Rajandeep Singh Gupta ◽  
Shyam Kumar Gupta ◽  
Asim Rafiq Laharwal
Keyword(s):  
Bilirubin Level ◽  
Serum Bilirubin ◽  
Tertiary Care ◽  
Serum Bilirubin Level ◽  
Care Hospital ◽  
Government Medical College ◽  
Medical College ◽  
Perforation Peritonitis ◽  
Average Serum ◽  
Appendiceal Perforation

Background: This study aims to assess the relationship between appendiceal perforation peritonitis and serum bilirubin levels, as has been reported previously in the literature.Methods: A retrospective observational study was conducted at tertiary care hospital of India, namely Government Medical College-Srinagar, Maulana Azad Medical College-Delhi and Government Medical College-Jammu over a period of five years (January 2014 to December 2018). Authors collected and analysed the data of 306 patients, who had reported to the surgery emergency of the afore mentioned hospitals with complaints of acute abdominal pain and were later confirmed and managed as appendiceal perforation peritonitis (localized or generalized). Also, liver function tests of these 306 patients had been sent at the time of admission.Results: Authors had 202 males and 104 females with an average age of 35 years in this study group. Hyperbilirubinemia was noted in 226 patients, with an average serum bilirubin level 1.8 mg/dl. In patients having total leucocyte counts higher than 11000 cells/cumm, the average serum bilirubin level was 2 mg/dl.Conclusions: It may be safely concluded that a pre-operative evaluation of serum bilirubin levels may help us in better diagnosing appendiceal perforation when used in conjunction with other routine and advanced diagnostic modalities.

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