scholarly journals A Study of Neonatal Hyperbilirubinemia in Mid-Western Part of Nepal

2017 ◽  
Vol 15 (2) ◽  
pp. 41-43 ◽  
Author(s):  
K.M. Roma ◽  
Piush Kanodia ◽  
Manita Pyakurel ◽  
Veena Gupta
Keyword(s):  
Neonatal Jaundice ◽  
Hospital Admissions ◽  
Serum Bilirubin ◽  
Study Data ◽  
Neonatal Hyperbilirubinemia ◽  
Treatment Modalities ◽  
Total Serum ◽  
Common Cause ◽  
Abo Incompatibility ◽  
Satisfactory Outcome

Introduction: Neonatal hyperbilirubinemia is a common cause of hospital admissions. Serum Bilirubin depends on birth weight and gestational age. Common causes of neonatal jaundice are physiological jaundice, breast feeding/milk jaundice, prematurity and pathological causes. Surmount total serum bilirubin over critical level, crosses the blood brain barrier leading to kernicterus. Prompt identification and proper management is of great importance otherwise there is a risk of bilirubin encephalopathy. Objectives: To find out the prevalence and causes of neonatal jaundice in our setting and treatment modalities undertaken. Materials and methods: A hospital based descriptive study was done among total newborns including both inborn and out born admitted in NICU, NGMC over the period of one year. A total 288 newborns with jaundice were enrolled in the study .Data were entered in excel and th analyzed in SPSS 18 version. Descriptive data were presented through pie, bar graph, and table with frequency and percentage. Results: Prevalence of neonatal jaundice was 31%. Causes of neonatal jaundice were physiological and pathological in 56% and 44% cases respectively. Among the pathological causes ABO incompatibility was the most common cause seen in 11.4% cases followed by sepsis seen in 8.7% cases. Conclusions: Phototherapy is very effective treatment modality to reduce the serum bilirubin in most of the cases neonatal hyperbilirubinemia and if the bilirubin crosses the cut off limit according to Bhutani's chart then we have to consider exchange transfusion. Appropriate management in time leads to satisfactory outcome.

Prevalence and Etiology of Neonatal Jaundice in a Tertiary Care Hospital

2021 ◽  
Vol 18 (2) ◽  
pp. 35-38
Author(s):  
Niraj Acharya ◽  
Chandra Prasad Paneru
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Sepsis ◽  
Neonatal Intensive Care ◽  
Neonatal Jaundice ◽  
Serum Bilirubin ◽  
College Teaching ◽  
Total Serum ◽  
Common Cause ◽  
Medical College

Introduction: Neonatal jaundice is a major clinical condition worldwide occurring in upto 60% of term and 80% preterm newborn in the first week of life. Neonatal jaundice is defined as total serum bilirubin level above 7 mg/dl. Aims:  This study was done to find out the prevalence and etiology of neonatal jaundice in neonates admitted to Neonatal Intensive Care Unit (NICU) of Nepalgunj Medical College Teaching Hospital (NGMCTH) Kohalpur, Banke. Methods: It was a prospective cross sectional hospital based study conducted from November 2018 to November 2019 in Neonatal Intensive Care Unit of Nepalgunj Medical College Teaching Hospital. All neonates with clinical jaundice and hyperbilirubinemia with total serum bilirubin of ≥7 mg/dl were subjected to complete history taking, through physical examination and investigations. Results: Out of 892 neonates who developed clinical jaundice, 640 neonates whose parents gave consent were included in the study. The prevalence of neonatal jaundice was found to be 39.85% with male to female ratio of 1.79:1. In the present study pathological jaundice was seen in 74.94% whereas physiological jaundice in 23.66%. Among the various etiologies of pathological jaundice, neonatal sepsis (44.52%) was found to be the most common cause followed by ABO incompatibility (12.18%) and Rh incompatibility (7.03%). Conclusion: The prevalence of neonatal jaundice in present study was 39.85% and the most common cause was neonatal sepsis .The prevalence of jaundice was more in preterm than in term neonates. Neonatal jaundice is very common morbidity in NICU especially in preterm babies.

scholarly journals Effectiveness of conventional phototherapy, intensive phototherapy and exchange transfusion in treating neonatal jaundice at Fatima Al-Zahra Hospital for maternity and children in Baghdad

2020 ◽  
Vol 16 (2) ◽  
pp. 25-29
Author(s):  
Ahmed Salih Marzoog ◽  
Hussein Naeem Mohammed ◽  
Kholod Dhaher Habib
Keyword(s):  
Exchange Transfusion ◽  
Neonatal Jaundice ◽  
Neonatal Care ◽  
Neonatal Hyperbilirubinemia ◽  
Total Serum ◽  
Common Disease ◽  
Female Ratio ◽  
Abo Incompatibility ◽  
Rh Incompatibility ◽  
Neonatal Care Unit

Background: Neonatal hyperbilirubinemia is a common disease in neonates especially in early days of birth that requires a good and successful treatment for reducing the severity and its complications that can produce important and irreversible effects. Objectives: To evaluate the effectiveness of conventional phototherapy, intensive phototherapy and exchange transfusion on outcomes of neonatal jaundice at Fatima Al-Zahra Hospital for maternity and child care in Baghdad. Patients & Methods: A retrospective study was carried out using medical records of neonates with diagnosis of unconjugated jaundice, admitted in the septic neonatal care unit of Fatima Al-Zahra hospital over 6 months period between 1st May till 31st October 2018. The total serum bilirubin, fractionations and blood group were done in all cases. They treated with conventional phototherapy, intensive phototherapy and exchange transfusion according to the severity of jaundice. Results: Total neonates admitted from 1st may to 31st October 2018 in septic neonatal care unit were 1254, among them 432 (35%) were diagnosed as unconjugated neonatal jaundice “indirect hyperbilirubinemia”. Male: Female ratio (1.4:1), males 256(59.3%), females 176(40.7%). Physiological jaundice was the most common cause 129(29.9%) cases. Prematurity in 104(24.1%) and ABO incompatibility 59(13.7%) while Rh incompatibility 14(3.2%), sepsis 8(1.9%) and unknown causes of jaundice were 118(27.3%) because lack of lab facilities. Conventional phototherapy was the most common kind of treatment in 237(55%) while intensive phototherapy used in 175(40.3%) cases with successful reduction in T.S.B level and the rate of improvement without need for exchange transfusion (92%) (161/175).Only 20(4.5%) cases were treated with exchange transfusion especially for ABO incompatibility 8 (42.1%) cases and Rh incompatibility 4 (21.1%) cases. Most of neonates 429 (99.3%) discharged with complete improvement and only 2 (0.5%) neonates suffered from kernicterus and one death (0.2%). Conclusion: Conventional phototherapy is still the standard treatment of mild to moderate indirect hyperbilirubinemia. Use of intensive phototherapy in the treatment of unconjugated neonatal hyperbilirubinemia is effective in reducing T.S.B level, need for exchange transfusion and hospital staying. Recommendations: provide aseptic neonatal care unit in the hospital with further number of intensive phototherapy devices as it is so effective in treating unconjugated neonatal jaundice and reduces need for exchange transfusion as it is proven in the study.

scholarly journals The Impact of Phototherapy on the Accuracy of Transcutaneous Bilirubin Measurements in Neonates: Optimal Measurement Site and Timing

Diagnostics ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. 1729
Author(s):  
Shau-Ru Ho ◽  
Yu-Chen Lin ◽  
Chi-Nien Chen
Keyword(s):  
Neonatal Jaundice ◽  
Serum Bilirubin ◽  
Pearson Correlation ◽  
Neonatal Hyperbilirubinemia ◽  
Total Serum ◽  
Transcutaneous Bilirubin ◽  
Optimal Measurement ◽  
The Impact ◽  
Transcutaneous Bilirubinometer ◽  
Time Point

Transcutaneous bilirubinometer devices are widely applied to assess neonatal hyperbilirubinemia. However, the optimal skin site and timing of transcutaneous bilirubin (TCB) measurements for the strongest correlation with total serum bilirubin (TSB) levels after phototherapy are still unclear. We conducted a retrospective observational study evaluating the correlation of TCB and TSB levels in neonates postphototherapy. The TCB measurements on the forehead and mid-sternum at 0 and 30 min postphototherapy were assessed by using a JM-103 bilirubinometer. Paired TCB and TSB measurements were assessed by Pearson correlation and Bland–Altman plots. We analyzed 40 neonates with 96 TSB and 384 TCB measurements. The TSB level correlated moderately with the forehead TCB level at 30 min postphototherapy (r = 0.65) and less strongly with the midsternum TCB level at 0 min postphototherapy (r = 0.52). The forehead at 30 min after cessation of phototherapy was the best time point and location of TCB measurement for the assessment of neonatal jaundice status. The reliability of TCB measurements varied across skin sites and durations after phototherapy. The effectiveness of TCB measurement to assess neonatal hyperbilirubinemia is much better on covered skin areas (foreheads) 30 min postphototherapy. The appropriate application of transcutaneous bilirubinometers could aid in clinical practice and avoid unnecessary management.

scholarly journals Transcutaneous billirubinometry to estimate total serum bilirubin in neonatal jaundice

2017 ◽  
Vol 57 (1) ◽  
pp. 8 ◽  
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.

EFFECT OF PHOTOTHERAPY ON SERUM CALCIUM LEVELS IN NEONATAL JAUNDICE

2021 ◽  
pp. 17-19
Author(s):  
Aradhana Gupta ◽  
Anand Kumar Bhardwaj ◽  
Anisha Aggarwal ◽  
Gauri Chauhan
Keyword(s):  
Serum Calcium ◽  
Neonatal Intensive Care ◽  
Neonatal Jaundice ◽  
Serum Bilirubin ◽  
Calcium Supplementation ◽  
Clinical Signs ◽  
Total Serum ◽  
Medical Sciences ◽  
Term Neonates ◽  
Unconjugated Hyperbilirubinemia

Background :To study the effect of phototherapy on serum calcium levels in neonates with unconjugated hyperbilirubinemia. Methods : This hospital based longitudinal interventional study was conducted on 100 neonates with neonatal hyperbilirubinemia admitted to Neonatal Intensive Care Unit at Maharishi Markandeshwar Institute of Medical Sciences and Research, Mullana, Ambala. Total serum bilirubin and serum calcium levels of each participants were checked before and at the end of phototherapy. Neonates were also checked for the clinical signs of hypocalcemia i.e. jitteriness, irritability, lethargy, and convulsions. Results : Atotal of 100 neonates with neonatal jaundice were included with 55% boys and 45 % girls whose mean age was 3.0 ± 0.95 days. Mean S.Bilirubin level before phototherapy was 13.92 ± 2.32 mg/dl which was reduced to 8.87 ± 2.18 mg/dl. S.Calcium levels pre-phototherapy were 8.66 ± 0.65 mg/dl which were reduced to 7.94 ± 1.05 mg/dl. It was found that 32% of the participants in total exhibited symptoms related to hypocalcemia. More term neonates (56.3%) experienced symptoms related to hypocalcemia compared to pre-terms (43.8%). Conclusion : It can be deduced that phototherapy induced hypocalcemia is a signicant concern and hence, neonates requiring phototherapy may be considered for calcium supplementation.

scholarly journals Effectiveness of phototherapy with reflecting curtains on neonatal jaundice

2011 ◽  
Vol 51 (5) ◽  
pp. 256 ◽  
Author(s):  
Ari Kurniasih ◽  
Guslihan Dasa Tjipta ◽  
Muhammad Ali ◽  
Emil Azlin ◽  
Pertin Sianturi
Keyword(s):  
Neonatal Jaundice ◽  
Serum Bilirubin ◽  
Low Cost ◽  
Total Serum Bilirubin ◽  
Spectral Irradiance ◽  
Total Serum ◽  
Control Group ◽  
Study Group ◽  
Term Newborns ◽  
The Mean

Background Although phototherapy has been used in clinical practice for 40 years, there is still much debate on how to provide the most efficacious phototherapy. Phototherapy with white reflecting curtains may increase the average spectral irradiance provided, as well as decrease serum bilirubin concentrations at a faster rate in neonates with jaundice.Objective To determine if adding low cost, white, reflecting curtains to a standard phototherapy unit can increase the effectiveness of phototherapy for neonatal jaundice.Methods A randomized, controlled, open trial was conducted at H. Adam Malik and Pirngadi Hospitals, Medan, from May to December 2009. The criteria for inclusion in the study were full term newborns with neonatal jaundice presenting in their first week of life. Single phototherapy with white curtains hanging from the sides of the phototherapy unit (study group, n=30) was compared to single phototherapy without curtains (control group, n=30). The primary outcomes measured were the mean difference in total serum bilirubin levels and average spectral irradiation levels measured at baseline, and after 12 hours and 24 hours of phototherapy.Results The sum of average spectral irradiance in the curtained phototherapy unit was significantly higher than that of the standard phototherapy unit without curtains (P < 0.05). The decrease of total serum bilirubin levels after 12 and 24 hours of phototherapy was significantly greater in the study group (3.71 and 9.7 mg/dl, respectively) than in the control group (0.1 and 3.8 mg/dl, respectively), both P <0.05.Conclusion White, reflecting curtains in phototherapy units was significantly more effective than phototherapy without curtains for treatment of neonatal jaundice. [Paediatr Indones. 2011;51:256-61].

scholarly journals Adverse Events of Exchange Transfusion in Neonatal Hyperbilirubinemia

2014 ◽  
Vol 34 (1) ◽  
pp. 7-13 ◽  
Author(s):  
M Chitlangia ◽  
GS Shah ◽  
P Poudel ◽  
OP Mishra
Keyword(s):  
Adverse Events ◽  
Respiratory Distress ◽  
Exchange Transfusion ◽  
Serum Bilirubin ◽  
Tertiary Care ◽  
Neonatal Hyperbilirubinemia ◽  
Total Serum Bilirubin ◽  
Total Serum ◽  
Bilirubin Encephalopathy ◽  
The Common

Introduction: Jaundice is an important problem during neonatal period. When total serum bilirubin (TSB) level exceeds a critical limit, it crosses the blood brain barrier and results into bilirubin encephalopathy. The main aim of therapy for neonatal hyperbilirubinemia is prevention of bilirubin encephalopathy by phototherapy and/or exchange transfusion. The aims of this study were to evaluate the efficacy of exchange transfusion (ET) and observe the adverse events during and following three days of ET in neonates with hyperbilirubinemia. Materials and Method: Hospital based cross-sectional descriptive study. All neonates admitted to neonatal intensive care unit and /or paediatric wards of a tertiary- care centre between September 2010 to March 2012, requiring ET were enrolled. Results: A total of 139 ETs were performed in 120 neonates. The common causes were ABO incompatibility (30.8%), prematurity (30.8%), idiopathic (27.5%), Rh isoimmunization (6.7%) and cephalhematoma (4.2%). Mean pre- ET total serum bilirubin (TSB) was 24.2 mg% dL. There was 58% reduction in TSB in post ET and 31% net reduction in 6 hr post ET. Term and preterm neonates showed equal percentage of TSB reduction. Respiratory distress (10.8%) and bradycardia (6.7%) were the common adverse events during, and hypocalcemia (98.3%) and thrombocytopenia (34.2%) in 3 days following ET. The sick neonates had significantly higher incidence of thrombocytopenia (p= 0.031), respiratory distress (p=0.009), apnea (p<0.001) and cardiorespiratory arrest (p<0.001). Overall mortality was 4.2%, and non-survivors were mostly low birth weight, born outside the present hospital and had higher incidence of adverse events. Conclusion: Exchange transfusion is an effective intervention in reducing the serum bilirubin level. However, these neonates require monitoring of ionised calcium and thrombocytopenia. Sick neonates had higher incidence of adverse events than healthy and close clinical monitoring is needed to improve the outcome. DOI: http://dx.doi.org/10.3126/jnps.v34i1.9030   J Nepal Paediatr Soc 2014;34(1):7-13

scholarly journals Outcome of Neonatal Hyperbilirubinemia from a Tertiary Care Hospital in Eastern Nepal: A Cross-sectional Study

2021 ◽  
Vol 4 (1) ◽  
pp. 37-42
Author(s):  
Shyam Prasad Kafle ◽  
Mukesh Bhatta ◽  
Ramesh Shrestha ◽  
Sarita Sitaula ◽  
Namu Koirala ◽  
...  
Keyword(s):  
Exchange Transfusion ◽  
Serum Bilirubin ◽  
Cross Sectional Study ◽  
Neonatal Hyperbilirubinemia ◽  
Total Serum Bilirubin ◽  
Total Serum ◽  
Sectional Study ◽  
Cross Sectional ◽  
Bilirubin Encephalopathy ◽  
Poor Outcome

Background: Timely detection and treatment of pathological hyperbilirubinemia in newbornscan prevent acute bilirubin encephalopathy and its consequences. We aimed to identifyitsoccurrence, presentationtime, phototherapyduration, need for exchange transfusion,and outcome. Methods: In this cross-sectional study, we enrolled all the babies admitted for pathological neonatal hyperbilirubinemia in the university hospital ofBPKIHSin a one-yearduration. Babies with life-threatening congenital malformations or conjugated bilirubin >20% of total serum bilirubin or >2 mg/dl were excluded. Obstetric profile of mothers, clinical and laboratory parameters of babies, onset time of pathological jaundice, duration of phototherapy, need for exchange transfusion or intravenous immunoglobulin were recorded. Neonatal outcome was classified as good and poor and its association with potential predictors analyzed.  Results: One-hundred and fifty babiesdeveloped neonatal jaundice requiring treatment. The most common causes includedABO and Rh setting. No cause was found in 26 (18%) babies. One-hundred and eight babies (72%) were only managed withphototherapy whereas 42 (28%) required both phototherapy and double volume exchange therapy. The majority (84.5%) had good outcome without any residual neurological deficit at discharge.Babies with total serum bilirubin >20 mg/dl at presentation, duration of phototherapy >44.8 h, ABO setting, hemolysis, and out born statussignificantly developed poor outcome (p < 0.05). Conclusion: About 15% of the babies with hyperbilirubinemia had acute bilirubin encephalopathy at discharge suggestive of poor outcome. Babies with high bilirubin at presentation, longer duration of phototherapy, ABO settings, hemolysis, and out born statusdeveloped poor outcome.

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