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At least 19 recordsLinked to original sources
PubMed1989

Management of neonatal jaundice.

Neonatal jaundice is the commonest complication among newborn infants in Singapore. Treatment is only required when the jaundice becomes severe. The trans-cutaneous bilirubinometer is useful in screening for neonatal jaundice; it is fairly reliable at levels less than or equal to 200 mumol/l in fullterm babies. Phototherapy is the commonest form of treatment and is effective in almost all cases if high intensity phototherapy is also used. Exchange transfusion is now only rarely used in view of its known complications and relatively high mortality rate.

Exchange Transfusion, Whole Blood↗
PubMed1989

Evaluation of Minolta jaundicemeter and icterometer for assessment of neonatal jaundice.

Neonatal jaundice is an important disorder, because of its potential complication of kernicterus. Biochemical estimation of bilirubin can be unreliable with lots of interpersonal and interlaboratory variability. Minolta jaundicemeter and perspex icterometer were evaluated for their usefulness in assessment of neonatal jaundice. Thirty premature babies with hyperbilirubinemia were simultaneously studied with jaundicemeter, icterometer and their plasma bilirubin were estimated by AO Bilirubinometer. Babies were subdivided into three groups, viz., Group I upto 1500 g birth weight, Group II 1501-2500 g with gestation 33-34 weeks and Group III 1501-2500 g with gestation 35-36 weeks. There was a good correlation between minolta Jaundicemeter and plasma bilirubin with 'r' values of 0.84, 0.89 and 0.72 in Groups I, II and III, respectively. Except for Group III (r = 0.67), good correlation was found between icterometer and plasma bilirubin with 'r' value of 0.84 and 0.82 in Groups I and II, respectively.

Bilirubin↗
PubMed1982

Hepatobiliary ultrasonography as a diagnostic aid in neonatal jaundice.

Neonatal hepatitis and biliary atresia are disorders of early infancy that represent variable expressions of one entity. Clinical and extensive laboratory evaluation are unsatisfactory in distinguishing between the two diseases. The usefulness of hepatobiliary ultrasonography in the evaluation of neonatal jaundice is described in four infants. Ultrasonic diagnosis was substantiated by laparotomy, liver biopsy or autopsy. The performance of hepatobiliary ultrasonography is recommended in all cases of neonatal jaundice in order to differentiate between extrahepatic biliary obstruction and neonatal hepatitis.

Bile Ducts↗
PubMed1981

Glucose-6-phosphate dehydrogenase status and neonatal jaundice.

Neonatal jaundice and its relationship to glucose-6-phosphate dehydrogenase (G6PD) status of healthy, term Chinese infants was evaluated in 220 G6PD-deficient infants, 26 intermediate infants who were observed for 3 weeks, and 116 normal (control) infants. Each infant was free of isoimmunisation, cephalhaematomas, or contusions. The mode of labour, method of delivery, and type of feeds had no appreciable effect on daily bilirubin levels. "Elevated" physiological jaundice was associated with normal and G6PD-deficient status; there was no increased haemolysis. G6PD-deficient status was associated with jaundice significantly raised especially in the first week of life, and prolonged beyond that of the "elevated" physiological jaundice. Significantly increased though mild haemolysis was observed. Close surveillance is therefore required for G6PD-deficient infants at least for the first week of life, the period of increased risk. With G6PD-intermediate infants, only the usual measures for normal infants are required.

Bilirubin↗
PubMedDate not supplied

Treatment of physiological and pathological neonatal jaundice.

Neonatal jaundice (hyperbilirubinaemia) is a common condition and usually a benign transitional event that resolves without treatment. However, in some infants it can be a symptom of an underlying pathological condition, which is important to identify. If bilirubin levels necessitate it, treatment for jaundice involves phototherapy and/or exchange transfusion of donor blood. In cases of pathological jaundice the underlying cause must also be treated. Parental involvement is important to minimise the trauma of having a sick baby and its effect on bonding.

Exchange Transfusion, Whole Blood↗
PubMed1975

Factors affecting the increasing incidence of severe non-haemolytic neonatal jaundice.

Neonatal hyperbilirubinaemia is increasing in frequency. In view of conflicting evidence about the possible causes, retrospective analyses have been carried out among babies born during six months of 1974. Preliminary analysis confirmed the over-riding importance of preterm birth (before 37 weeks), but only one of 17 such cases could be attributed to ill-judged artificial induction of labor. For the main analysis, the incidence of eight possibly relevant antecedent factors was compared in 46 cases of hyperbilirubinaemia (unconjugated bilirubin more than 15 mg per 100 ml in term babies and more than 13 mg per 100 ml in some preterm babies) and in 92 controls matched for sex and gestational age. Induction of labour by "primary" oxytocin infusion and artificial rupture of the membranes was very significantly more common in the index cases (p less than 0-01), but there was no difference in the incidence of "secondary" oxytocin, used to accelerate spontaneous labour. Evidence of uterin unresponsiveness suggests that the natural onset of labour was being anticipated by at least some days in many of the index cases and this could prevent the natural "priming" of the fetal enzyme systems. An excess of epidural analgesia in the mothers of the index cases was probably due to its association with the need for pain relief during "primary" oxytocin infusions. The higher incidence of postnatal weight loss in the index cases presumably contributed to the hyperbilirubinaemia.

Anesthesia, Epidural↗
PubMed2005

Nils Rosén von Rosenstein and neonatal jaundice in the 18th century.

BACKGROUND: Nils Rosén von Rosenstein (1706-1773) was a Swedish nobleman and a professor at Uppsala University. His series of lectures on children's diseases and their treatment was published in 1764 under the title Underrättelser om Barn-Sjukdomar och Deras Bote-Medel. MATERIALS AND METHODS: Rosén von Rosenstein's book was translated into several languages. The present paper deals with the opinions and advice proffered on the jaundiced neonate in chapter 25 of the Danish edition from 1769. RESULTS: The distinction between jaundice in the neonate and jaundice in older children is not clear everywhere in the chapter, and much of Rosén von Rosenstein's advice on therapy appears to be intended for all age groups. Rosén von Rosenstein believed that neonatal jaundice was less common in Sweden than elsewhere, and ascribed this to the common practice of purging newborns with a manna sugar laxative. The principal cause of jaundice, according to Rosén von Rosenstein, was bile stasis. When milk curdled in the stomach, the curds could plug the common bile duct, and bile would be forced into the lymphatics and from there into the blood. Thus, the bile was carried around the body and caused the skin and the sclera, as well as other organs, to become yellow. Cure was usually easy-a laxative in the form of puréed manna with powdered rhubarb was what Rosén von Rosenstein recommended. CONCLUSION: Rosén von Rosenstein's opinions and advice concerning neonatal jaundice were not original, and did not differ from those found in other medical texts from the 18th and 19th centuries. The bile stasis explanation for all kinds of jaundice, including neonatal jaundice, was widely held in the 18th century, and continued to predominate in paediatric texts until the end of the 19th century. Similarly, laxatives and enemas as the cure-all for many ailments held sway until the late 1800s.

History, 18th Century↗
PubMed1975

Neonatal jaundice and glucose-6-phosphate dehydrogenase deficiency in Papua New Guinea.

Of 50 jaundiced neonatal patients studied at the Port Moresby General Hospital, 11 (22%) were found to be glucose-6-phosphate dehydrogenase-deficient. No apparent exogenous precipitating causes for the jaundice were noted. Serum bilirubin levels exceeded 20 mg/100 ml in seven of these glucose-6-phosphate dehydrogenase-deficient infants, and exchange transfusions were required for three subjects. Glucose-6-phosphate dehydrogenase deficiency must be considered in the differential diagnosis of neonatal jaundice in Papua New Guinea.

Bilirubin↗
PubMed1974

Survey of neonatal jaundice in Port Moresby.

Neonatal jaundice is a common problem in Port Moresby. A survey was carried out on 50 consecutive jaundiced neonates in an attempt to delineate the causes of severe neonatal jaundice (bilirubin 15 mg. % or more). ABO blood group incompatibility, G-6-P-D deficiency and infection accounted for 62% of cases while no cause could be found in 38% of cases. Low birth weight, multiple births, male sex, asphyxia, delivery occuring outside the hospital, and vacuum extraction were associated more commonly with jaundiced neonates than with the controls. There was a statistically significant association between the use of promethazine in the mother during and after labour and jaundice in the newborn. The association between the use of sulphonamides in the mother after delivery and neonatal jaundice was suggestive but not statistically significant.

ABO Blood-Group System↗
PubMed1986

Phototherapy for neonatal jaundice: clinical equivalence of fluorescent green and "special" blue lamps.

The relative efficacy of fluorescent green (Sylvania F20T12/G) and "special" blue (Westinghouse F20T12/BB) lamps in the phototherapy of jaundiced neonates was investigated. Two groups of low birth weight infants with a mean gestational age of 35 weeks and mean birth weight of 1930 gm, who developed hyperbilirubinemia within the first 5 days of life, were given green or blue lamp phototherapy under the same irradiation conditions. No statistically significant difference in plasma bilirubin concentrations was found between the two groups after 24 or 48 hours of treatment. Because recent measurements indicate that green lamps are much less efficient than special blue lamps for the production of Z, E isomers of bilirubin in vitro and in vivo, the clinical equivalence of these two types of lamps seems to support the hypothesis that production of structural photoisomers of bilirubin is the main mechanism of phototherapy in humans. Therefore, fluorescent green lamps provide an alternative to special blue lamps for treatment of neonatal hyperbilirubinemia.

Bilirubin↗
PubMed1986

Free and erythrocyte-bound bilirubin in neonatal jaundice.

Serum free bilirubin and erythrocyte-bound bilirubin concentrations were estimated in 53 jaundiced neonates with a total serum bilirubin concentration of 227.4 +/- 80.4 mumol/l. The serum free bilirubin and erythrocyte-bound bilirubin concentrations were 8.7 +/- 5.6 nmol/l and 23.8 +/- 6.0 mumol/l, respectively. Both, the serum free bilirubin (r = 0.741, p less than 0.001) and erythrocyte-bound bilirubin (r = 0.754, p less than 0.001) correlated directly with bilirubin-albumin molar ratio. There was a direct correlation between free and erythrocyte-bound bilirubin concentration (r = +0.657, p less than 0.001). The prediction of serum free bilirubin concentrations from the known erythrocyte-bound bilirubin value was unreliable.

Bilirubin↗
PubMed2006

Limitation of glucose oxidase method of glucose estimation in jaundiced neonates.

The most widely used method for estimation of plasma glucose is that adopted by Trinder's using glucose oxidase-peroxidase (GOD-POD) system. This method gives much lower blood glucose values with blood samples of neonatal jaundice (plasma bilirubin level > 10 mg/dL) of age 10 +/- 5 daysthan with samples of neonates of the same age group without jaundice or older children suffering from other diseases like acute respiratory distress, septicemia.

Glucose↗
PubMedDate not supplied

Can severe neonatal jaundice be prevented by neonatal screening for glucose-6-phosphate dehydrogenase deficiency?--a review of evidence.

An evidence-based approach is used to evaluate the neonatal screening program for glucose-6-phosphate dehydrogenase (G-6-PD) deficiency. The primary consideration to include G-6-PD deficiency (G-6-PDD) in neonatal screening program was the public health burden of G-6-PDD-associated neonatal jaundice (G-6-PDDANJ) in the target population. However, the prevalence of G-6-PDD per se cannot be the sole index of the public health burden of G-6-PDDANJ. In more developed areas, G-6-PDDANJ is no longer a major public health problem. Further, most cases with G-6-PDDANJ in more developed areas are not precipitated by any identifiable icterogenic agents, and therefore not preventable by avoidance education. In less developed areas, however, G-6-PDDANJ is still a big public health burden and requires intervention. In this study, the effectiveness of neonatal screening programs for G-6-PDD to prevent severe neonatal jaundice(NJ) has been shown based on historical comparison, but the results may be confounded by other temporal factors. G-6-PDDANJ usually occurs in the first week after birth. Prompt need for G-6-PD screening results precludes it from incorporation into other existent neonatal screening programs (i.e., for PKU), and from centralization of laboratory work. The efficacy, adverse effects and cost-effectiveness of this mass screening program need further study.

Cost-Benefit Analysis↗
PubMed1992

Neonatal jaundice in Asia.

Neonatal jaundice is a major clinical problem globally, especially in the Asian and south-east Asian regions. There is no universal definition of hyperbilirubinaemia, and comparisons of management and control of hyperbilirubinaemia in infants at different centres are difficult. G6PD deficiency, ABO incompatibility, low birth weight and sepsis are the common causes of neonatal jaundice, but there is a group of babies whose cause of neonatal jaundice has yet to be found. Genetic factors may be responsible for ethnic differences in the ability to eliminate bilirubin, while unidentified environmental factors may also play a role in the prevalence of neonatal jaundice. As a result of a surveillance programme for neonatal jaundice in Singapore, involving health education of doctors, nurses and the lay public, screening of the newborn and the early treatment of jaundice, we have not seen a single case of kernicterus in Singapore for more than 10 years.

Asia↗
PubMed2000

Pioneers in the scientific study of neonatal jaundice and kernicterus.

Neonatal jaundice must have been noticed by caregivers through the centuries, but the scientific description and study of this phenomenon seem to have started in the last half of the 18th century. In 1785 Jean Baptiste Thimotée Baumes was awarded a prize from the University of Paris for his work describing the clinical course in 10 jaundiced infants. The work by Jaques Hervieux, which he defended for his doctor of medicine degree in 1847, was, in many respects, a landmark. He had autopsied 44 jaundiced infants and apparently had clinical observations on many others. His descriptions of pathoanatomical findings were very detailed and systematic. A number of his clinical observations are still thought to be accurate today, such as the essentially benign nature of neonatal jaundice in most cases, the appearance of neonatal jaundice during the first 2 to 4 days of life as well as its disappearance within 1 to 2 weeks, and the cephalocaudal progression of jaundice. He described jaundice of the brain in 31 of his 44 autopsied cases, with variable intensity of staining. Johannes Orth was an assistant to the famous Virchow in Berlin, when in 1875 he published the results of an autopsy of a jaundiced term infant. The brain was notable for an intense yellow staining of the basal ganglia, the wall of the third ventricle, the hippocampus, and the central parts of the cerebellum. While the contribution of Orth was limited to this single case report, in 1903 Christian Schmorl presented the results of his autopsies of 120 jaundiced infants to the German Society for Pathology. All of these infants' brains were jaundiced, but only 6 cases demonstrated a staining phenomenon similar to that previously described by Orth. Schmorl coined the term kernicterus (jaundice of the basal ganglia) for this staining pattern. Although the following century of scientific study has added an enormous amount of information about the epidemiology and pathophysiology of neonatal jaundice and kernicterus, the contributions of Hervieux, Orth, and Schmorl will undoubtedly continue to be seen as historical landmarks in our quest for understanding of these phenomena.

France↗