![]() Except for one infant, all the other infants were Rh compatible. Maximum number of infants was with ‘O’ blood type. Most the infants were delivered full term normally (N=126) only 24 infants were delivered through lower (uterine) segment Caesarean section. Significant number of infants weighed above 2.5 kg (148 infants). The male to female ratio was 0.97:1 (74 male and 76 female). The observed baseline characteristics of mothers and newborns are presented in. For well infants usually it can be adjusted around 16.5mg/dL i.e., around medium risk zone which is considered in our study. High risk at 72 hours is >13.5mg/dL, Medium risk is 16.5mg/dL and Low risk is >18mg/dL. The present hospital-based prospective study was undertaken to determine the predictive value of serum bilirubin before 6 hours of life for subsequent hyperbilirubinaemia in healthy term neonates.īirth Asphyxia (APGAR 35 weeks of gestation. Timed TSB measurements (at discharge between 18 hours and 72 hours) can be used to predict the chances of developing severe hyperbilirubinaemia. In the event of diagnosing jaundice, subsequent monitoring through TcB or TSB will depend on the nomogram zone. Transcutaneous bilimeter (TcB) and/or TSB measurement should be performed on every infant within 8–12 hour after birth. If total and direct bilirubin levels are beyond the normal limits (total bilirubin: 0.3–1.2mg/dL, direct bilirubin: 0.0–0.3 mg/dL) then liver disease could be suspected. Diagnosis of hyperbilirubinaemia with the aid of Kramer index could be deceptive, especially in children with dark skin. In general, neonatal jaundice is benign and no intervention might be required, but jaundice can be associated with an underlying disease condition, which therefore warrants accurate and unbiased estimation of bilirubin. However, the TSB levels might decline over time. A TSB level of >10mg/dL after the third week of life could be attributed to β-glucuronidases and non-esterified fatty acids in the breast milk that apparently inhibits normal bilirubin metabolism. One-third of exclusively breast-fed infants ara also likely to develop mild jaundice but in the third week of life and it may persist for few months. In case of pathological jaundice, the TSB levels are constantly increasing beyond the normal values from first day of birth. In neonates, physiological jaundice develops within 2–3 days of birth, with a rise in TSB levels to 6–8mg/dL or to a maximum of 12mg/dL on day 3 and subsequent fall in the TSB level within normal limits. Depending on the bilirubin levels, the jaundice may by physiological or pathological. īilirubin is the final breakdown product of hemoglobin that is excreted in the bile after conjugation. Besides the maternal risk factors, neonatal risk factors are birth trauma, certain drugs (sulfisoxazole acetyl, erythromycin ethyl succinate, chloramphenicol), excessive weight loss after birth, infections, infrequent feedings, male gender, polycythemia and delayed meconium passage. Other maternal risk factors are breastfeeding, drugs (diazepam, oxytocin), Asian, native American ethnicity, and gestational diabetes. Unmonitored and untreated hyperbilirubinaemia may lead to neurological complications and hence, it is important to identify hyperbilirubinaemia and initiate appropriate treatment.Ĭertain factors would predispose the infants to hyperbilirubinaemia and some of the common fetal-maternal risk factors include fetal-maternal blood group incompatibility, prematurity, and a previously affected sibling. Acute bilirubin encephalopathy and kernicterus are the two important neurological manifestations of hyperbilirubinaemia. Usually hyperbilirubinaemia occurs in the absence of any underlying diseases however, it may be associated with severe illnesses such as hemolytic disease, metabolic and endocrine disorders, anatomic abnormalities of the liver, and infections. Nearly 60% of term newborns present with clinical jaundice during the first week of life. ![]() Neonatal hyperbilirubinaemia, defined as a TSB >5 mg/dL, is a commonly encountered clinical condition among the newborns. ![]()
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