Neonatal jaundice ( icterus neonatrum/ neonatal hyperbilirubinemia). Couses,type and management. скачать в хорошем качестве

Neonatal jaundice ( icterus neonatrum/ neonatal hyperbilirubinemia). Couses,type and management.

Neonatal jaudice... Definition-- Yellowish coloration of skin and mucusa due to increase level of unconjugated bilirubin. Bilirubin is the product of breakdown of RBC. Jaundice start from head and letter extend to chest , abdomen , arm and legs. Jaundice appears last in palm of hand and 16 feet. Incidence- 60% in term & 80% in preterm baby. Types of neonatal jaudice--- Physiological jaundice Pathological jaundice. Physiological jaundice— It appears after 24 hours of delivery. In term baby maximum level at 4th day and subside by 7th day of delivery. In preterm baby maximum level at 5th / 6th day and subside by 14th day after delivery. Serum bilirubin does not exceed 15mg/dl. Usually disappears by 7- 10 day in term & 14 day in preterm. Subside spontaneously and no need of treatment. Mother needs encouragement for exclusive breastfeeding for adequate hydration. 2. Pathological jaundice- It appears within 24 hours delivery and present more than 10 days in term and 14 day in preterm baby. Bilirubin level is increasing by more than 50 mg per DL per day. TB- 15mg/dl,, DB- 2mg/dl. Palms and soles are yellow. Clay colour stool. Couses of neonatal jaundice--- Physiological- Faster distruction of RBC. Liver is immature. Insufficient intestinal bacteria flora. 2. pathological- Rh incompatibility. Less production of glucuronyl transferase enzyme. Dificiency of G6PD enzyme. Management--- Phototherapy. Phenobarbitone therapy. Exchange transfusion.