|Care of the Jaundiced Neonate|
Chapter 9. Prevention, Screening, and Postnatal Management of Neonatal HyperbilirubinemiaM. Jeffrey Maisels and Thomas B. Newman
Topics Discussed: gastroenterology and hepatology; hyperbilirubinemia; kernicterus; neonatal jaundice; neonatology.
Sections: Physiologic and Pathologic Jaundice, Primary Prevention, Preventing Hyperbilirubinemia, Identifying the Jaundiced Newborn, Transcutaneous Bilirubin Measurements, Risk Assessment, Follow-Up, Helping the Practitioner to Implement Guidelines, Pharmacologic Prevention of Hyperbilirubinemia, Intervention in the Breastfeeding Jaundiced Newborn, Conclusions, References.
Excerpt:"As noted in several other chapters in this book, bilirubin encephalopathy and kernicterus are still occurring throughout the world with population-based estimates of incidence in North America and Europe ranging from 0.5 to 2.4 cases per 100,000 live births1 (Table 9-1). In contrast to the early clinical case descriptions, most of the infants who now develop kernicterus are not those with Rh disease and they often have no documented evidence of hemolytic disease.9 Many are term and late preterm infants who have been discharged from the nursery as "healthy newborns," yet have returned to a pediatrician's office, a clinic, or an emergency department with total serum bilirubin (TSB) levels often exceeding 30 mg/dL9and have gone on to develop the classic neurodevelopmental findings associated with kernicterus.10 There is also a smaller group of infants, more difficult to identify, who suffer an unanticipated precipitous increase in the TSB while still in the hospital or soon after discharge and present with acute bilirubin encephalopathy.9,11,12 Glucose-6-phosphate dehydrogenase (G6PD) deficiency is an important cause of the hyperbilirubinemia in some of these infants.9,12
The content above is only an
excerpt. For full access, log into an existing user account below, purchase an annual subscription, or
purchase a short-term subscription to the complete website.
offers pediatrics students,
educators, and practioners access to leading McGraw-Hill texts, interactive imaging
content, exclusive multimedia, and flexible curricular tools.
Timed access to all of AccessPediatrics
24 hours for $34.95
48 hours for $54.95