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Definition:-
Neonatal jaundice is a condition that occurs in newborn infants, characterized by yellowing of the skin and yellowing of the eyes due to an accumulation of bilirubin in the bloodstream. or
Neonatal Jaundice refers to yellowing of the skin, sclera, body fluid, due to excessive disposition of bilirubin in the blood and occurs in newborn /infant
Bilirubin is a waste product produced when the body breaks down red blood cells, and it is normally eliminated from the body through the liver. However, in newborns, the liver may not be fully developed and unable to process bilirubin effectively, leading to its accumulation in the bloodstream and subsequent jaundice.
Types of Neonatal Jaundice & Causes of Neonatal jaundice:-
Physiological jaundice or jaundice of the newborn
- It appears after 24 hours of delivery
- In term baby's maximum level AT 4th day and stable subside by 7th day of delivery
- In Pritam baby's maximum level at the 5th or 6th day and subside by the 14th day of delivery
- Bilirubin level in mature babies should be less than 10 mg/dl or in preterm babies less than 15 mg/dl.
- Not present more than 10 days and 14 days in free download
Causes:-
- faster destruction of RBC because of the shorter lifespan of 80 days and more fetal HP level of 18 to 24 mg/dl
- The liver is immature so decreases the secretion of the enzyme glucuronyl transferase
- Insufficient intestinal commensals bacterial flora
Pathological Jaundice
- It appears within 24 hours of delivery and presents for more than 10 days in term & 14 days in preterm babies
- 5% of newborn babies develop pathological jaundice
- bilirubin level increase at the rate of 5 mg/100ml
Causes:-
- Rh incompatibility or hemolytic disease of newborn {Commenets}
- ABO incompatibility {rare}
- Excessive destruction of RBC because of excessive Hb level and shorter life span of RBC
- less production of glucurunyl transferase enzyme by the liver due to immature liver
- Deficiency of RBC enzyme, glucose-6 phosphate dehydrogenase (G6PD), which causes hemolytic anemia.
- G6PD deficiency is an inherited disorder transmitted as an X-linked (sex-linked) receive trait.
Neonatal jaundice Signs and Symptoms:
The main symptom of neonatal jaundice is the yellowing of the skin and whites of the eyes. Other symptoms may include:
- Yellowish discoloration of the skin, sclera, and nail
- Poor feeding and lethargy
- Dark urine
- Pale stools
- High-pitched cry
- loss of more reflex
- Enlarged liver or spleen
Complication:-
- Kernicterus ( neurotoxicity caused by excessive bilirubin)
- Transient encephalopathy:-
Diagnosis:-
- Serum level of bilirubin above 5mg/dl.
- Clinical estimation of jaundice:-
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Treatment for neonatal jaundice Or Management of jaundice:-
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1) Phototherapy ( Light Therapy ) Or Phototherapy for neonatal jaundice
Phototherapy: This involves exposing the baby to blue-green (Fluorescent) light, which helps to break down the bilirubin in the skin and bloodstream.
How Phototherapy works for jaundice?
Ans:- Phototherapy emits a specific wavelength of light that is absorbed by the skin and changes the structure of bilirubin. The altered bilirubin is then excreted from the body through the urine and stools.
Complications of Phototherapy:-
1) hyperpyrexia II) Dehydration III) Irritability & transient skin rash
2) Exchange transfusion:
In severe cases, a blood transfusion may be necessary to replace the baby's blood with healthy donor blood.
3) Fluids and nutrition: Ensuring the baby is well hydrated and receiving adequate nutrition is important to support liver function and eliminate bilirubin from the body.
Jaundice in newborns When to worry?
If you notice yellowing of the skin or eyes in your newborn, it's important to monitor the severity and seek medical attention if it becomes worse or spreads to the abdomen. You should also seek medical attention if your baby is not feeding well or is lethargic, or if there are signs of dehydration or fever.
In conclusion, neonatal jaundice is a common condition affecting newborn infants. While it usually resolves on its own, it is important to monitor the baby's bilirubin levels and seek medical attention if necessary to prevent complications.
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