child health notes

Apr 16th, 2015
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NEONATAL JAUNDICEDefinition The yellow color of the skin and sclerae resulting from thedeposition of bilirubin in these easily observable tissues The yellow coloration of the skin and sclera in newborns withjaundice is the result of accumulation of unconjugated bilirubin The condition arises when the rate of bilirubin productionexceeds the rate at which bilirubin is eliminated.Epidemiology Jaundice is a common neonatal problem. 65% of newborns develop clinical jaundice with a bilirubin levelabove 5 mg/dL during the first week of life. However, significant jaundice occurs in 6 % of term babiesEtiologyUnconjugated Hyperbilirubinemia Unconjugated bilirubin is the direct breakdown product ofheme, is water insoluble, and is measured as indirect bilirubin The causes of unconjugated hyperbilirubinemia can be groupedinto two main categories: overproduction of bilirubin anddecreased conjugation of bilirubinOverproduction of bilirubin Increased rate of hemolysis (reticulocyte count elevated)1. Rh incompatibility2. ABO blood group incompatibility3. Other blood group sensitizations4. Abnormal red cell shapes: Spherocytosis, Elliptocytosis,Pyknocytosis, and Stomatocytosis5. Red cell enzyme abnormalities: Glucose-6-phosphatedehydrogenase deficiency6. Sepsis: bacterial, viral, or protozoa Nonhemolytic causes of increased bilirubin load (Unconjugatedbilirubin elevated, reticulocyte count normal.)1. Extravascular hemorrhage

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