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Neonatal jaundice after first week of life

Elif Bahat Ozdogan, Mehmet Mutlu, Secil Arslansoyu Camlar, Gülcin Bayramoglu, Sebnem Kader, Yakup Aslan
BACKGROUND: It is controversial to test for urinary tract infection (UTI) in patients with unexplained indirect hyperbilirubinemia in the first 2 weeks of life. We aimed to study the prevalence and significance of UTIs in such neonates who were requiring phototherapy. METHODS: Subjects were 2- to 14-day-old neonates with indirect bilirubin levels above phototherapy limit with no other abnormality in their bilirubinaemia-related etiologic workup. UTI was diagnosed by 2 consecutive positive cultures obtained by catheterisation, documenting growth of >10,000 colonies of the same microorganism with consistent antibiograms...
October 28, 2017: Pediatrics and Neonatology
Bolajoko O Olusanya, Tina M Slusher, Donald O Imosemi, Abieyuwa A Emokpae
BACKGROUND: Mothers are frequently the first to observe the onset of jaundice in their newborn infants before the decision to seek treatment. However, simple-to-use tools that could facilitate early detection of jaundice and assist mothers to seek professional care, especially after hospital discharge, are rare. This study therefore, set out to evaluate the performance of a -two-color icterometer (Bilistrip™) as a possible screening tool for detecting significant jaundice by mothers or care-givers in the first week of life...
2017: PloS One
Heidi Smedegaard, Vibeke Brix Christensen, Morten Hanefeld Dziegiel, Marianne Hørby Jørgensen
This case report presents a newborn boy with hypoglycaemia, anaemia, jaundice and severe coagulopathy during the first day of his life, imitating sepsis and disseminated intravascular coagulation. One week after the birth he was diagnosed with acute liver failure due to gestational alloimmune liver disease (GALD). Despite the fact that GALD is rare, it must be suspected in all unexplained stillborn children and infants with severe liver disease. If diagnosed, it is possible to prevent death and severe liver failure in future newborns by treating the affected women with immunoglobulin during pregnancy...
March 27, 2017: Ugeskrift for Laeger
A Cortey, L Renesme, J Raignoux, A Bedu, C Casper, P Tourneux, P Truffert
Jaundice due to unconjugated bilirubin is an everyday condition in the neonatal period because it results from the adaptation of bilirubin metabolism at this time of life. Hyperbilirubinemia has a potential neurotoxicity and although it most often resolves spontaneously, it can lead to acute and sometimes chronic encephalopathy. The latter condition is called kernicterus and induces severe and irreversible neurological sequelae. This rare complication is still reported in all countries throughout the world even if severe hyperbilirubinemia can be prevented and critical points points of failure in jaundice management are identified...
February 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
Rima Fawaz, Ulrich Baumann, Udeme Ekong, Björn Fischler, Nedim Hadzic, Cara L Mack, Valérie A McLin, Jean P Molleston, Ezequiel Neimark, Vicky L Ng, Saul J Karpen
Cholestatic jaundice in infancy affects approximately 1 in every 2500 term infants and is infrequently recognized by primary providers in the setting of physiologic jaundice. Cholestatic jaundice is always pathologic and indicates hepatobiliary dysfunction. Early detection by the primary care physician and timely referrals to the pediatric gastroenterologist/hepatologist are important contributors to optimal treatment and prognosis. The most common causes of cholestatic jaundice in the first months of life are biliary atresia (25%-40%) followed by an expanding list of monogenic disorders (25%), along with many unknown or multifactorial (eg, parenteral nutrition-related) causes, each of which may have time-sensitive and distinct treatment plans...
January 2017: Journal of Pediatric Gastroenterology and Nutrition
Mustafa Aydın, Fırat Hardalaç, Berkan Ural, Serhat Karap
Neonatal jaundice is a common condition that occurs in newborn infants in the first week of life. Today, techniques used for detection are required blood samples and other clinical testing with special equipment. The aim of this study is creating a non-invasive system to control and to detect the jaundice periodically and helping doctors for early diagnosis. In this work, first, a patient group which is consisted from jaundiced babies and a control group which is consisted from healthy babies are prepared, then between 24 and 48 h after birth, 40 jaundiced and 40 healthy newborns are chosen...
July 2016: Journal of Medical Systems
Rehana A Salam, Jai K Das, Chesarahmia Dojo Soeandy, Zohra S Lassi, Zulfiqar A Bhutta
BACKGROUND: Infections during pregnancy confers increased risk of maternal and perinatal morbidity and mortality. However, the case for advocating Haemophilus influenzae type B (Hib) and viral Influenza vaccinations in pregnancy is still debatable. OBJECTIVES: To assess the impact of Hib and viral Influenza vaccinations during pregnancy on maternal, neonatal and infant health outcomes compared to placebo/control. SEARCH METHODS: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (29 January 2015) and reference lists of retrieved studies...
June 9, 2015: Cochrane Database of Systematic Reviews
Samantha J Lain, Christine L Roberts, Jennifer R Bowen, Natasha Nassar
OBJECTIVES: To examine the association between early discharge from hospital after birth and readmission to hospital for jaundice among term infants, and among infants discharged early, to investigate the perinatal risk factors for readmission for jaundice. METHODS: Birth data for 781,074 term live-born infants born in New South Wales, Australia from 2001 to 2010 were linked to hospital admission data. Logistic regression models were used to investigate the association between postnatal length of stay (LOS), gestational age (GA), and readmission for jaundice in the first 14 days of life...
February 2015: Pediatrics
Peymaneh Alizadeh Taheri, Mandana Sadeghi, Negar Sajjadian
BACKGROUND: Severe neonatal hyperbilirubinemia is associated with significant morbidity and mortality. This study was conducted to investigate the causes of severe hyperbilirubinemia leading to Exchange Transfusion (ET) from March 2009 to March 2011 in Bahrami children hospital, Tehran, Iran in order to establish guidelines to prevent profound jaundice & ET. METHODS: 94 neonates underwent ET for severe hyperbilirubinemia data for demographic data, and onset of jaundice, history of severe hyperbilirubinemia in siblings, blood group of both mother and neonate, G6PD activity, hemoglobin, hematocrite, reticulocyte count, peripheral blood smear, total and direct bilirubin before and after ET, direct and indirect Coombs, times of transfusion and the cause of hyperbilirubinemia were all recorded for analysis...
2014: Medical Journal of the Islamic Republic of Iran
Margarita Ramonet, Mirta Ciocca, Fernando Alvarez
Biliary atresia is a serious disease of unknown cause, affecting newborns. An inflammation and progressive destruction of the bile ducts lead to jaundice, dark urines, and acholia, between the second and sixth weeks of life. Neonatal cholestasis could be due to several different diseases, thus a diagnosis of biliary atresia and early derivation for surgical treatment are necessary to allow a restoration of the bile flow. Eighty percent of the children normalize serum bilirubin after the portoenterostomy (Kasai operation), if they are operated before their 45 days of life...
December 2014: Archivos Argentinos de Pediatría
Youyou Zhou, San-Nan Wang, Hong Li, Weifeng Zha, Qianqian Peng, Shilin Li, Ying Chen, Li Jin
OBJECTIVE: To explore the effects of variants in Uridine Diphosphate Glucuronosyl Transferase 1A1 (UGT1A1) and Heme Oxygenase-1 (HMOX1) on daily physiological bilirubin levels and bilirubin changes during the first week after birth in Chinese newborns. Both UGT1A1 and HMOX1 code rate-limiting enzymes in the bilirubin metabolism pathway. STUDY DESIGN: We conducted a retrospective quantitative trait study to analyze 4154 daily bilirubin values, 3129 bilirubin changes, and 11 polymorphisms of 988 newborns during the natural course of physiological hyperbilirubinemia...
December 2014: Journal of Pediatrics
Noureen Afzal, Maqbool Qadir, Sonia Qureshi, Rehan Ali, Shakeel Ahmed, Khalil Ahmad
Neonatal Hyperbilirubinaemia is a common finding during the first postnatal week. Physiological jaundice occurs in first week of life in 60% of term and 80% of premature neonates. Non physiologic or pathologic jaundice occurs in 5-10% of newborns which require intervention. According to AAP guidelines laboratory investigation for jaundice include total serum bilirubin, blood Type and coombs test and if the baby has an elevation of direct reacting or conjugated bilirubin, there should be a urine analysis and urine culture...
July 2012: JPMA. the Journal of the Pakistan Medical Association
Intan Juliana Abd Hamid, Mohd Igbal Iqbal M Iyen, Nor Rosidah Ibrahim, Noorizan Abd Majid, Noraida Ramli, Hans Van Rostenberghe
AIM: The use of reflecting curtains with single phototherapy has not yet been directly compared with double phototherapy (DP). The objective of this study is to compare the efficacy of single phototherapy with reflecting curtains (SPRC) and DP in treating neonatal jaundice. METHODS: This randomised controlled trial involved 160 term newborns with severe neonatal jaundice in the first 2 weeks of life. The subjects were randomised in two groups: the intervention group receiving SPRC (n = 80) and a control group receiving DP (n = 80)...
May 2013: Journal of Paediatrics and Child Health
A Jain, D Puri, M M Faridi
Double volume (170 ml/kg body weight) exchange transfusion was done in 52 term infants in the first week of life for neonatal hyperbilirubinemia. The M:F ratio was 1.08:1 and 37 (71.1%) babies were of low birth weight. Causes of jaundice were hemolytic in 46.2% and non-hemolytic in 41.3% cases; in 13.5% babies no cause of jaundice could be found. After exchange transfusion a fall of 14.6% and 47.4% was observed in the hemoglobin and serum bilirubin levels respectively. There was significant (p=0.0414) rise in the mean mid exchange and post-exchange serum sodium levels as compared to pre-exchange values and it was found to be due to higher donor's serum sodium levels (p=0...
July 1997: Indian Journal of Clinical Biochemistry: IJCB
K Radha Lavanya, Ashish Jaiswal, Pramod Reddy, Srinivas Murki
OBJECTIVES: To study (i) the incidence and course of jaundice, and (ii) the predictors of significant jaundice in late preterm infants. DESIGN: Prospective analytical study. SETTING: Urban perinatal center. PATIENTS: Inborn late preterm infants (post menstrual age of 34 0/7 to 36 6/7 weeks). METHODS: Infants were followed till day 14 of life or till onset of significant jaundice. Relevant maternal, perinatal and neonatal variables were prospectively recorded...
September 2012: Indian Pediatrics
Sanjiv Harpavat, Milton J Finegold, Saul J Karpen
OBJECTIVES: Healthy infants are thought to acquire biliary atresia (BA) in the first weeks of life. Because those diagnosed earlier have better outcomes, we were interested in determining the earliest time BA could be detected. We started by examining the immediate postnatal period, hypothesizing that newborns would not yet have acquired disease and still have normal direct/conjugated bilirubin (DB/CB) levels. PATIENTS AND METHODS: Newborn DB/CB levels were obtained retrospectively from birth hospitals...
December 2011: Pediatrics
Hamilton P Schwartz, Beth E Haberman, Richard M Ruddy
It is estimated that about two thirds of newborns will appear clinically jaundiced during their first weeks of life. As newborns and their mothers spend fewer days in the hospital after birth, the number of infants readmitted yearly in the United States for neonatal jaundice over the last 10 years has increased by 160%. A portion of these infants present to the emergency department, requiring a careful history and physical examination assessing them for the risk factors associated with pathologic bilirubin levels...
September 2011: Pediatric Emergency Care
Giuseppe Fiermonte, Giovanni Parisi, Diego Martinelli, Francesco De Leonardis, Giuliano Torre, Ciro Leonardo Pierri, Alessia Saccari, Francesco Massimo Lasorsa, Angelo Vozza, Ferdinando Palmieri, Carlo Dionisi-Vici
Citrin is the liver-specific isoform of the mitochondrial aspartate/glutamate carrier (AGC2). AGC2 deficiency is an autosomal recessive disorder with two age related phenotypes: neonatal intrahepatic cholestasis (NICCD, OMIM#605814) and adult-onset type II citrullinemia (CTLN2, OMIM#603471). NICCD arises within the first few weeks of life resulting in prolonged cholestasis and metabolic abnormalities including aminoacidemia and galactosuria. Usually symptoms disappear within the first year of life, thus making a diagnosis difficult after this time...
December 2011: Molecular Genetics and Metabolism
C Chardot, D Debray
Every neonatal jaundice lasting more than 2 weeks needs urgent investigations, beginning with examination of stools colour, and blood tests with total and conjugated serum bilirubin. If neonatal cholestasis (NC) is confirmed, vitamin K should be immediately injected, and the child should be referred to a specialised centre for investigations and treatment. Biliary atresia (BA) is the first cause of NC. Its diagnosis is urgent, since the chance of success of the conservative surgical treatment (Kasai operation or variants) decreases rapidly as the age at surgery increases...
April 2011: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
Ruth De Bruyne, Stephanie Van Biervliet, Saskia Vande Velde, Myriam Van Winckel
Neonatal cholestasis is a serious condition which requires urgent further investigation. Delayed referral of cholestatic neonates, however, is still a significant problem. Every child presenting with jaundice beyond the age of 2 weeks should be evaluated with a fractionated bilirubin checked. In case of neonatal cholestasis, the first step should be the assessment of coagulation and urgent parenteral vitamin K administration in case of coagulopathy and the exclusion of life-threatening conditions or disorders requiring urgent specific treatment...
March 2011: European Journal of Pediatrics
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