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

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  

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

2014 ◽  
Vol 115 (1-2) ◽  
pp. 33-42 ◽  
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.

scholarly journals ROLE OF HYPERBILIRUBINEMIA IN PREDICTON OF GANGRENOUS/PERFORATED APPENDICITIS

2021 ◽  
Vol 5 (7) ◽  
Author(s):  
Irfan Hussain Khan ◽  
Arun Bhargava
Keyword(s):  
Acute Appendicitis ◽  
Prospective Study ◽  
Bilirubin Level ◽  
Diagnostic Tool ◽  
Liver Enzymes ◽  
Serum Bilirubin ◽  
Perforated Appendicitis ◽  
Total Serum Bilirubin ◽  
Total Serum

Introduction: The aim of this study was to determine the role of hyperbilirubinemia as a new diagnostic tool for predictor of gangrenous / perforated appendicitis. Methods: Hospital based prospective study was conducted on 100 patients with perforated/gangrenous appendix Results: In acute appendicitis case out of 84 cases 26 cases bilirubin level was more than 1mg/dl, in gangrenous appendicitis out of 3 cases all cases bilirubin level was more than 1mg/dl and in perforated appendicitis out of 13 cases 12 cases bilirubin level was more than 1mg/dl Conclusion: It is concluded from present study that elevated total serum bilirubin without elevation of liver enzymes is a good indicator of appendicular perforation. Keywords: Perforation, Appendicitis, Bilirubin

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