STUDY OF CLINICAL AND SUBCLINICAL CHARACTERISTICS IN NEONATAL HYPERBILIRUBINEMIA

2017 ◽  
pp. 84-89
Author(s):  
Thi Thanh Binh Nguyen ◽  
Thi Phuong Thao Tran ◽  
Hung Viet Phan
Keyword(s):  
Serum Bilirubin ◽  
Clinical Problem ◽  
The Body ◽  
Neonatal Hyperbilirubinemia ◽  
Total Serum Bilirubin ◽  
High Rate ◽  
Total Serum ◽  
Term Infants ◽  
Cross Sectional ◽  
Hands And Feet

Background: Neonatal hyperbilirubinemia is a common clinical problem encountered during the neonatal period, especially in the first week of life. It is a multifactorial disorder with many symptoms. Most of these cases are benign but it is important to identify those babies at risk of acute bilirubin encephalopathy and kernicteurs or chronic encephalopathy. Jaundice may also be a sign of a serious underlying illness. Objectives: Describe and examine the relationship between clinical characteristics with laboratory tests of indirect hyperbilirubinemia in neonatal. Methods: A cross-sectional descriptive. A convenient sample includes 124 patients under 28 days old had jaundice and were treated at Neonatal room, Hospital of Hue University of Medicine and Pharmacy from 05/2015 to 06/2016. Results: The proportion of male/female is 1.3/1. 66.9% is in term infants. 73.4% onset of jaundice in 24 - 72 hours of age. 67.7% had jaundice all the body before were taken to neonatal room. 47.6% cases were caused by neonatal infection. 93.5% cases had total serum bilirubin < 340 µmol/L. It has a weak positive correlation between the degree of clinical jaundice with level of total serum bilirubin. 31/124 cases suspected ABO incompatibility but Coombs test were negative, however they had high rate of anemia than the others is 13.2 times (p<0.01). Conclusions: Indirect hyperbilirubinemia in neonatal is usually detected when the baby had jaundice to hands and feet. Therefore precautionary measure should be adopted by both parents and clinicians to diagnose and treat the disease properly. Key words: jaundice, hyperbilirubinemia, neonatal

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.

scholarly journals Unconjugated Neonatal Hyperbilirubinemia: Evaluation and Treatment

2020 ◽  
Vol 19 (2) ◽  
pp. 31-40
Author(s):  
Zaid T Yaseen ◽  
◽  
Jalil I Alezzi ◽  
Suad M Khaleel
Keyword(s):  
Exchange Transfusion ◽  
Serum Bilirubin ◽  
Daily Practice ◽  
Cross Sectional Study ◽  
Total Serum Bilirubin ◽  
Total Serum ◽  
Term Infants ◽  
Cross Sectional ◽  
Unconjugated Hyperbilirubinemia ◽  
Abo Incompatibility

Background: Neonatal jaundice is a common problem with a lot of faults that may happen during its management. Objective:To study the epidemiological features of the unconjugated hyperbilirubinemia(UHB)in Diyala Governorate and discuss the proper lines of therapy, as well as to discuss the daily practice adopted in our hospital, and its complications. Patients and Methods: A cross-sectional study included 100 neonates (term and preterm babies) with unconjugated hyperbilirubinemia aged 0-7 days who were admitted to the Al-Batool Teaching Hospital in Baqubah, Iraq, from 1st February 2018 to the 1st November 2018. Term infants with total serum bilirubin (TSB) ≥ 22mg/dL were treated with exchange transfusion and phototherapy (Group A, 44 neonates). Those with total serum bilirubin levels from 13-<22mg/dL were treated with phototherapy only (Group B, 56 neonates). These decisions were made according to the TSB level and risk factors. Results: Forty-eight percent of neonates had hemolytic causes (Rh-isoimmunization 13%; ABO-incompatibility 10%; G6PD-deficiency 25%). Other include: sepsis 8%; prematurity 33%; congenital CMV infection 1%; and there were 10% had no evidence of hemolysis or other serious problems. The mortality rate was 3.8% of those who had an exchange transfusion. Conclusion: The decision of kind of treatment is dependent on the underlying etiology of unconjugated hyperbilirubinemia. Keywords: Unconjugated hyperbilirubinemia, Neonates, complications

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

2017 ◽  
Vol 39 (3) ◽  
pp. 116-122 ◽  
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

scholarly journals Can bilirubin/albumin ratio predict neurodevelopmental outcome in severe neonatal hyperbilirubinemia? A 3-month follow up study

2021 ◽  
Vol 69 (1) ◽  
Author(s):  
Reem M. Soliman ◽  
Iman F. Iskander ◽  
Esraa A. Elmazzahy ◽  
May A. K. Abdellatif
Keyword(s):  
Serum Bilirubin ◽  
Tertiary Care ◽  
Neurodevelopmental Outcome ◽  
Neonatal Hyperbilirubinemia ◽  
Total Serum Bilirubin ◽  
Total Serum ◽  
Early Management ◽  
Albumin Ratio ◽  
Auditory Evoked Response

Abstract Background The risk of kernicterus and BIND may be in part determined by total serum bilirubin (TSB) and by the level of non-albumin bound free bilirubin, which can easily pass the blood–brain barrier. Free bilirubin (Bf) seems a more reliable predictor for bilirubin neurotoxicity. Bilirubin/albumin ratio (B/A) is considered a surrogate parameter for Bf and has been more useful than TSB. The aim of the study is to determine whether B/A ratio correlates with BIND in newborns with severe hyperbilirubinemia and if it can predict poor neurologic outcome at 3 months follow up. Results This prospective study included one hundred seventeen outborn neonates ≥ 35 weeks admitted in a tertiary care neonatal intensive care unit, between May and December 2012, with TSB ≥ 20 mg/dl or necessitating exchange transfusion. Total serum bilirubin and serum albumin were done on admission and bilirubin/albumin ratio was calculated. BIND score was calculated. At the age of 3 months, 112 neonates were followed up with a detailed neurological assessment. Babies who depicted any abnormal motor examination were subjected to brain stem auditory evoked response and MRI examination. Seven infants (6.2%) presented with kernicterus on follow up. BIND scores on admission, mean TSB, and bilirubin/albumin ratio was significantly higher in kernicteric infants compared with those having normal neurological outcome at 3 months of age (P 0.001). The lowest TSB level at which kernicterus occurred in our study was 31 mg/dl. Receiver operation characteristics analysis identified B/A ratio cut off value for predicting kernicterus of 9.6 with sensitivity of 100% and specificity of 91.4%, whereas TSB cut off value of 30 mg/dl showed sensitivity of 100% and specificity of 83%. Conclusion B/A ratio is a strong indicator for the risk of kernicterus. B/A is more specific than TSB and should be used in the early management of neonatal hyperbilirubinemia.

scholarly journals Comparison of light emitting diode and compact fluorescent lamp phototherapy in treatment of neonatal hyperbilirubinemia

2017 ◽  
Vol 4 (2) ◽  
pp. 341 ◽  
Author(s):  
Maharoof M.K. ◽  
Shamshad Ahmed Khan ◽  
Prakash Robert Saldanha ◽  
Reshad Mohamed
Keyword(s):  
Gestational Age ◽  
Serum Bilirubin ◽  
Light Emitting Diode ◽  
Neonatal Hyperbilirubinemia ◽  
Total Serum Bilirubin ◽  
Total Serum ◽  
Fluorescent Lamp ◽  
Light Emitting ◽  
The Mean ◽  
Compact Fluorescent Lamp

Background: High levels of total serum bilirubin can cause life threatening complications in neonates requiring management either with phototherapy or exchange blood transfusion. Most commonly used modality of phototherapy is with blue light. There are many bulbs like fluorescent tubes, halogen spotlights etc. Due to disadvantages of the available bulbs, newer method like light-emitting diodes (LEDs) has been investigated as possible alternatives as they produce low heat, has a longer life span with lower energy consumption and rapid reduction of serum bilirubin level. The aim was to compare the efficacy between phototherapy equipped with light emitting diode (LED) to compact fluorescent lamp (CFL) in the treatment of neonatal hyperbilirubinemia among neonates.Methods: A hospital-based intervention study was conducted among 50 neonates born in the hospital during the study period, with gestational age more than equal to 35 weeks, being breastfed and healthy in a private medical college teaching hospital in Dakshina Kannada district from August to September 2016.  Following ethical committee clearance the neonates looking icteric by clinical examination were randomly allocated to receive CFL or LED phototherapy. Baseline, 24 hour total serum bilirubin and rectal temperature was measured.  Results: A total of 50 neonates were randomly allocated into two groups with almost similar characteristics between the two groups with respect to gender, type of delivery and gestational age. The mean bilirubin values (in mg/dl) among neonates in the CFL group and LED group were 14.8 and 15.6 respectively and post 24 hour values were 11.54 and 10.68 respectively. The mean difference in the reduction in the bilirubin values before and after receiving phototherapy between the two groups were significant (p <0.001). The increase in temperature was lesser among LED treatment group.Conclusions: LED therapy is better than the CFL therapy in terms of mean reduction in the total serum bilirubin after a fixed duration of time and lesser raise in temperature among the neonates.  

scholarly journals A comparison of serum and transcutaneous methods for diagnosis of neonatal hyperbilirubinemia

2017 ◽  
Vol 5 (7) ◽  
pp. 2887
Author(s):  
Mehran Hesaraki
Keyword(s):  
Serum Bilirubin ◽  
Descriptive Study ◽  
T Test ◽  
Neonatal Hyperbilirubinemia ◽  
Total Serum Bilirubin ◽  
Total Serum ◽  
Simple Test ◽  
Non Invasive ◽  
Lab Test

Background: Bili-Check is a simple test for non-invasive, quick, and painless estimation of the total serum bilirubin. This research aimed to compare serum and transcutaneous methods for the diagnosis of neonatal hyperbilirubinemia.Methods: In this descriptive study, a sample of 120 neonates diagnosed with hyperbilirubinemia was selected using convenience non-probability. They were hospitalized in Amir Al-Momemin Hospital of Zabol, Iran in 2013. The extent of neonatal bilirubin was measured by NINGBO DAVID and lab test. Then, they were compared. The data were analyzed using correlation and t-test in SPSS 22.Results: In this descriptive study, a sample of 120 neonates diagnosed with hyperbilirubinemia was selected using convenience non-probability. They were hospitalized in Amir Al-Momemin Hospital of Zabol, Iran in 2013. The extent of neonatal bilirubin was measured by NINGBO DAVID and lab test. Then, they were compared. The data were analysed using correlation and t-test in SPSS 22.Conclusions: The results showed that Bili-Check can be recommended as an appropriate tool for screening and monitoring phototherapy process. The serum method can be replaced by Bili-check.

scholarly journals The Predictive Value of Day one Serum Bilirubin Extent for Subsequent Increase Substantial Hyperbilirubinemia in Well Full Term Neonate in Mukalla Maternity and Child Hospital, Hadhramout,Yemen

2021 ◽  
Vol 20 (2) ◽  
pp. 1-13
Author(s):  
Saleh Awad Bahwal ◽  
◽  
Mazin Ahmed Jawass ◽  
Faiza Salmeen Naji
Keyword(s):  
Predictive Value ◽  
Serum Bilirubin ◽  
Predictive Ability ◽  
Cross Sectional Study ◽  
Neonatal Hyperbilirubinemia ◽  
Total Serum ◽  
Serum Total Bilirubin ◽  
Subsequent Increase ◽  
Cross Sectional ◽  
Child Hospital

Background: Significant neonatal hyperbilirubinemia is a common cause of readmission following initial sending home from hospitals in healthy mature neonates. Objective: To determine the predictive ability of first 24th hr entire serum bilirubin (TSB) levels for later development of important hyperbilirubinemia in well mature neonates at Mukalla Maternity and Child Hospital (MMCH) in Mukalla city, Hadhramaut Governorate, Yemen. Patients and Methods: A cross sectional study of 150 well mature newborns was tracked with everyday serum total bilirubin detections for five days of life at Mukalla Maternity & Child Hospital between March 2019 and February 2020. Results: It was observed that 10%, 10%, 13.3% and 66.7%% of newborns were corresponding to high, high intermediate, low intermediate, and low risk zones respectively, while7.3% of newborns had developed significant hyperbilirubinemia and needed phototherapy. The day one bilirubin value of 5mg/dl had a sensitivity of 100% and specificity of 72%, the positive predictive value of 22%, and a negative predictive value of 100% in forecasting the risk of developing significant jaundice. Conclusion: A total serum bilirubin measurement may be applied as a useful screening test for each neonate at the first week of life, to foresee those at risk for later development of significant neonatal hyperbilirubinemia and permit for a harmless discharge from the hospital.

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