| Written by Dr.Md.Redwanul Huq (Masum) |
| Monday, 16 January 2012 06:51 |
Clinical assessment of Jaundice in neonate:
In case of neonate- jaundice can be assessed clinically by yellow coloration of skin due to bilirubin –
| Area of the body |
Corresponding serum level of bilirubin (mg/dl) |
| FaceChest, upper abdomenLower abdomen, thighArms, legsPalms of hands, soles of foot |
4 -68 -1012 -1415 – 1815 -20 |
Management of neonatal jaundice:
1. Management of jaundice in healthy term neonates
(Term babies having jaundice clinically before 24 hours of age are not considered as healthy neonates)
| Age of the neonate |
Total serum level of bilirubin (mg/dl) & Management |
| 25 -48 hours49 – 72 hoursMore than 72 hours |
More than 15More than 18More than 20(Phototherapy is the management of choice) |
More than 20More than 25More than 25(Exchangetransfusion is the management of choice) |
More than 25More than 30More than 30(ExchangeTransfusion & intensive phototherapy is the management of choice) |
2. Management of jaundice in LBW babies
| Age of the neonate |
Total serum level of bilirubin (mg/dl) & Management |
| 750 -1000 hours1000 -1250 hours1250 -1500 hours1500 -2500 hours |
6 -108 -1010 -1215 -18(Phototherapy is the management of choice in these cases of neonatal jaundice) |
More than 1515 -1817 -2020 -25(Exchange transfusion is the management of choice in these cases of jaundice in neonate) |
3. Prophylactic use of Phenobarbitone
Phenobarbitone is used prophylactically in a dose of 5 mg/kg for the first 3 -5 days.
Indications:
1. Preterm babies
2. Neonates with haemolytic jaundice
3. Neonates with extravasated blood without any significant side effect.
