Neonatal jaundice: Difference between revisions
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== Diagnosis == | == Diagnosis == | ||
#Direct (conjugated, post- liver obstructive) | |||
##congenital biliary atresia | |||
obstructive | ##neuroblastoma | ||
##cholesterol cysts | |||
#Cellular | |||
##hepatitis | |||
##galactosemia | |||
##sepsis | |||
##TORCHS | |||
##tyrosinemia | |||
##alpha 1 antitrypsis deficiency | |||
#Iindirect (unconjugated, pre-liver) | |||
##sepsis | |||
##hypotension | |||
##rH/ ABO incompatibility | |||
== <span class="Apple-style-span" style="line-height: normal; border-collapse: collapse"><font color="#000000">Work-Up</font></span> == | == <span class="Apple-style-span" style="line-height: normal; border-collapse: collapse"><font color="#000000">Work-Up</font></span> == | ||
Revision as of 06:46, 12 March 2011
Risk Factors
- Isoimmune hemolytic disease
- G6PD deficiency
- Asphyxia
- Significant lethargy
- Temperature instability
- Sepsis
- Acidosis
- Albumin <3 g/d (if measured)
Diagnosis
- Direct (conjugated, post- liver obstructive)
- congenital biliary atresia
- neuroblastoma
- cholesterol cysts
- Cellular
- hepatitis
- galactosemia
- sepsis
- TORCHS
- tyrosinemia
- alpha 1 antitrypsis deficiency
- Iindirect (unconjugated, pre-liver)
- sepsis
- hypotension
- rH/ ABO incompatibility
Work-Up
1) Tbil
2) Dbil
3) CBC (for hemolytic anemia)
4) Coombs or T&S (mom & baby)
5) ?blood resorption
6) ?septic
7) ?Decreased gastric motility
8) Physiologic/breast milk (none @ birth presents 1st week)
PHOTOTHERAPY GUIDELINES
| Age | Low | Med | High |
| Birth | 7.0 | 5.0 | 4.0 |
| 24h | 11.5 | 9.0 | 8.0 |
| 48h | 15 | 14 | 10 |
| 72h | 17.5 | 15 | 14 |
| 96h | 20 | 17.5 |
14.5 |
| 5+day | 21 | 17.5 | 15 |
Low Risk: >=38wk + no risk factors
Med Risk: (>=38wk + risk factors) or (35-37 wk and no risk factors)
High Risk: 35-37wk + risk factors
Source
DONALDSON 10/07 (from UpToDate), Mistry, DeBonis