1) Baby X developed jaundice 18hrs after delivery and admitted in the NBU A)state 2 causes of pathological jaundice??? b) state 4 test performed on the cord blood to confirm the diagnosis to a baby of a Rhesus-ve mother??? C) management of baby X discharge???? D) state 4 infection prevention practice in NBU
The jaundice which is developed after the birth need not necessarily be pathological as in the case of Erythroblastosis Fetalis (Rh incompatibility). The neonatal jaundice is common in all the children because it used to have Fetal Hemoglobin(HbF) which now has to be replaced with HbA(adult hemoglobin). Thus as a compensatory mechanism the fetal RBCs undergo massive massacre leading to excessive heme catabolism or excessive bile formation which leads to jaundice!!!
Causes pathologic jaundice include sepsis, rubella, toxoplasmosis, occult hemorrhage and erthroblastosis fetalis
Investigation Serum Blood Test Normal values of total bilirubin are from 0.3 to 1.0 mg/dl. In a newborn, higher bilirubin is normal due to the stress of birth. Normal bilirubin in a newborn would be under 5 mg/dl, but many newborns have some kind of jaundice and bilirubin levels above 5 mg/dl In general, a total bilirubin level above 1.9 mg/dl is considered elevated. The normal range for total bilirubin level in the blood is 0.3 to 1.9 mg/dl. Direct, or conjugated, bilirubin normally ranges from 0 to 0.3 milligrams per deciliter
Management Before treatment is initiated, the minimum evaluation should include the infant’s age and postnatal course, a maternal and gestational history, physical examination of the infant, and determination of the total serum bilirubin level and the rate at which it is rising Mild infant jaundice often disappears on its own within two or three weeks. For moderate or severe jaundice, your baby may need to stay longer in the newborn nursery or be readmitted to the hospital. Treatments to lower the level of bilirubin in your baby’s blood may include: Light therapy (phototherapy)
