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Neonatal Jaundice PowerPoint Presentation

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Description : Check out this medical PowerPoint presentation titled "Neonatal jaundice” by Dr.K.L.Chaitanya.

This medical PowerPoint presentation is about neonatal jaundice, also known as neonatal hyperbilirubinemia. Neonatal jaundice is a common condition in newborns characterized by high levels of bilirubin in the blood, which can cause yellowing of the skin and whites of the eyes. Bilirubin is a yellow pigment that is formed when red blood cells are broken down in the body. In newborns, the liver is not fully developed, and the excess bilirubin cannot be efficiently processed and eliminated from the body. This leads to the accumulation of bilirubin in the blood, which causes jaundice.

Neonatal jaundice is usually harmless and resolves on its own within a few weeks, but in some cases, it can become severe and require medical intervention. Risk factors for severe neonatal jaundice include premature birth, low birth weight, a family history of jaundice, and certain medical conditions such as blood type incompatibility between the mother and baby.

Treatment for neonatal jaundice typically involves phototherapy, which involves placing the baby under special lights that help break down the bilirubin in the blood. In severe cases, exchange transfusion may be necessary, which involves removing the babys blood and replacing it with donor blood.

It is important for parents to monitor their baby for signs of jaundice and seek medical attention if they notice yellowing of the skin or whites of the eyes, poor feeding, or lethargy. Regular check-ups with a pediatrician can help ensure that any potential issues with neonatal jaundice are detected and treated promptly.

Tags : Neonatal jaundice, neonatal hyperbilirubinemia, bilirubin in the blood, Neonatal-Perinatal Medicine, Neonatal-Perinatal Medicine PowerPoint presentation

Published on : Jun 07, 2023 | Views : 1222 | Downloads : 12

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NEONATAL JAUNDICE Dr.K.L.Chaitanya Asst.professor paediatrics
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What is the Neonatal Jaundice? Neonatal Jaundice(also called Newborn jaundice) is a condition marked by high levels of bilirubin in the blood. The increased bilirubin cause the infant's skin and whites of the eyes (sclera) to look yellow.
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Neonatal Jaundice Visible form of bilirubinemia Adult sclera >2mg / dl Newborn skin >5 mg / dl Occurs in 60% of term and 80% of preterm neonates However, significant jaundice occurs in 6 % of term babies Teaching Aids: NNF NJ - 3
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Special characteristic in neonates 1.More billirubin produced Much more Hemolysis The life-length of hemolysis(70~80)
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Special characteristic in neonates 2.The low capability of albumin on unconjugated billirubin transportation acid intoxication Less albumin in neonates
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Special characteristic in neonates 3.The low capability of heptatocyte Less Y protein and Z protein The primary development of Hepato-enzyme system Easy-broken hepato-enzyme system After-born, the blood glucose level is very low.
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Special characteristic in neonates 4.High workload of the hepato-enteric circulation Less bacterial Low enzymatic activity in intestine High level of billirubin in meconium
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A little exam Increased rbc’s Shortened rbc lifespan Immature hepatic uptake & conjugation Increased enterohepatic Circulation
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Grading of extent of jaundice 2
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Clinical assessment of jaundice Area of body Bilirubin levels mg/dl Face 4-8 Upper trunk 5-12 Lower trunk & thighs 8-16 Arms and lower legs 11-18 Palms & soles > 15 Teaching Aids: NNF NJ - 11
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Physiological jaundice Characteristics Appears after 24 hours Maximum intensity by 4th-5th day in term & 7th day in preterm Serum level less than 15 mg / dl Clinically not detectable after 14 days Disappears without any treatment Note: Baby should, however, be watched for worsening of jaundice Teaching Aids: NNF NJ - 12
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Pathological jaundice Appears within 24 hours of age Increase of bilirubin > 5 mg / dl / day Serum bilirubin > 15 mg / dl Jaundice persisting after 14 days Stool clay / white colored and urine staining clothes yellow Direct bilirubin> 2 mg / dl Teaching Aids: NNF NJ - 13
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Causes of jaundice Appearing within 24 hours of age Hemolytic disease of NB : Rh, ABO Infections: TORCH, malaria, bacterial G6PD deficiency Appearing between 24-72 hours of life Physiological Sepsis Polycythemia Concealed hemorrhage Intraventricular hemorrhage Increased entero-hepatic circulation Teaching Aids: NNF NJ - 14
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Causes of jaundice After 72 hours of age Sepsis Cephalhaematoma Neonatal hepatitis Extra-hepatic biliary atresia Breast milk jaundice Metabolic disorders Teaching Aids: NNF NJ - 15
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Common causes in India Physiological Blood group incompatibility G6PD deficiency Bruising and cephalhaematoma Intrauterine and postnatal infections Breast milk jaundice Teaching Aids: NNF NJ - 16
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Approach to jaundiced baby birth weight gestation and postnatal age Assess clinical condition (well or ill) physiological or pathological Look for evidence of kernicterus* in deeply jaundiced NB *Lethargy and poor feeding, poor or absent Moro's, opisthotonus or convulsions Teaching Aids: NNF NJ - 17
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Workup Maternal & perinatal history Physical examination Laboratory tests (must in all)* Total & direct bilirubin* Blood group and Rh for mother and baby* Hematocrit, retic count and peripheral smear* Sepsis screen Liver and thyroid function TORCH titers, liver scan when conjugated hyperbilirubinemia Teaching Aids: NNF NJ - 18
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Management Rationale: reduce level of serum bilirubin and prevent bilirubin toxicity Prevention of hyperbilirubinemia: early feeds, adequate hydration Reduction of bilirubin levels: phototherapy, exchange transfusion, drugs Teaching Aids: NNF NJ - 21
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Principle of phototherapy Native bilirubin Photo isomers of bilirubin Insoluble Soluble Teaching Aids: NNF NJ - 22 450-460nm of light
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Phototherapy equipment White light tubes 6-8*/ 4 blue light tubes Cradle or incubator Eye shades *May use 150 W halogen bulb Teaching Aids: NNF NJ - 24
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Phototherapy Technique Perform hand wash Place baby naked in cradle or incubator Fix eye shades Keep baby at least 45 cm from lights, if using closer monitor temperature of baby Start phototherapy Teaching Aids: NNF NJ - 25
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Phototherapy Frequent extra breast feeding every 2 hourly Turn baby after each feed Temperature record 2 to 4 hourly Weight record- daily Monitor urine frequency Monitor bilirubin level Teaching Aids: NNF NJ - 26
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NJ - 27 Key point in the practical execution of phototherapy 1-The infant should be naked except for diaper , eye to be covered 2- distance between the skin and light source . 3-when used spotlight , the infant is placed in centre . 4- routinely add 10-15% extra fluid . 5- timing of follow -up S.B testing must be individualized.
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NJ - 28
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Side effects of phototherapy Increased insensible water loss Loose stools Skin rash Bronze baby syndrome Hyperthermia Upsets maternal baby interaction May result in hypocalcemia Teaching Aids: NNF NJ - 29
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Choice of blood for exchange blood transfusion ABO incompatibility Use O blood of same Rh type, ideal O cells suspended in AB plasma Rh isoimmunization Emergency 0 -ve blood Ideal 0 -ve suspended in AB plasma or baby's blood group but Rh -ve Other situations Baby's blood group Teaching Aids: NNF NJ - 30
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DRUGS Phenobarbitone- increases y&z ligandin receptors-induces liver enzymes-increases conjugation Metalloporphyrins- tin&zinc-inhibits heme oxygenase IVIG- inhibits heamolysis Oral agar agar &cholestyramine- decreases entero hepatic circulation Albumin infusions-increases bilirubin binding
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Kernicterus Kernicterus is damage to the brain centers of infants caused by increased levels of unconjugated-indirect bilirubin which is free (not bound to albumin).
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Prolonged indirect jaundice Causes Crigler Najjar syndrome Breast milk jaundice Hypothyroidism Pyloric stenosis Ongoing hemolysis, malaria Teaching Aids: NNF NJ - 33
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Conjugated hyperbilirubinemia Suspect High colored urine White or clay colored stool Caution Always refer to hospital for investigations so that biliary atresia or metabolic disorders can be diagnosed and managed early Teaching Aids: NNF NJ - 34
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Conjugated hyperbilirubinemia Causes Idiopathic neonatal hepatitis Infections -Hepatitis B, TORCH, sepsis Biliary atresia, choledochal cyst Metabolic -Galactosemia, tyrosinemia, hypothyroidism Total parenteral nutrition Teaching Aids: NNF NJ - 35
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THANK YOU