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Neonatal jaundice is a yellowish discoloration of the white part of the eyes and skin in a newborn baby due to high bilirubin levels. [1] Other symptoms may include excess sleepiness or poor feeding. [1] Complications may include seizures, cerebral palsy, or kernicterus. [1] In most of cases there is no specific underlying physiologic disorder. [2]
Bilirubin should be tested from cord blood. [5] Ferritin - because most infants affected by HDN have iron overload, ferritin levels must be measured before giving the infant any additional iron. [11] Newborn Screening Tests - Transfusion with donor blood during pregnancy or shortly after birth can affect the results of the Newborn Screening Tests.
Newborn infant with Rhesus disease, a type of hemolytic disease of the newborn, suffering from hydrops fetalis (edema caused by heart failure). The infant did not survive. [4] Signs of hemolytic disease of the newborn include a positive direct Coombs test (also called direct agglutination test), elevated cord bilirubin levels, and hemolytic anemia.
Neonatal cholestasis refers to elevated levels of conjugated bilirubin identified in newborn infants within the first few months of life. [1] Conjugated hyperbilirubinemia is clinically defined as >20% of total serum bilirubin or conjugated bilirubin concentration greater than 1.0 mg/dL regardless of total serum bilirubin concentration. [2]
Kernicterus is a bilirubin-induced brain dysfunction. [1] The term was coined in 1904 by Christian Georg Schmorl.Bilirubin is a naturally occurring substance in the body of humans and many other animals, but it is neurotoxic when its concentration in the blood is too high, a condition known as hyperbilirubinemia.
Risk factors associated with high serum bilirubin levels include male gender, white ethnicities, and active smoking. [50] Mean serum total bilirubin levels in adults were found to be higher in men (0.72 ± 0.004 mg/dl) than women (0.52 ± 0.003 mg/dl). [50]
The four most common causes of hereditary hyperbilirubinemia include Gilbert syndrome, Crigler-Najjar syndrome, Dubin-Johnson syndrome, and Rotor syndrome.There are additional rare causes of hereditary hyperbilirubinemia like Lucey-Driscoll syndrome and Heme Oxygenase-1 Deficiency.
After that, the risk of an IUT is greater than the risk from post birth transfusion. [30] Steroids - Steroids are sometimes given to the mother before IUTs and early delivery to mature the fetal lungs. [30] [15] Phenobarbital - Phenobarbital is sometimes given to the mother to help mature the fetal liver and reduce hyperbilirubinemia. [15] [31]