1 / 16

Neonatal Jaundice SGD

Neonatal Jaundice SGD. Dr Saffiullah AP Paeds. By the end of this discussion you should be able to; 1.Make a differential diagnosis of common and significant causes of jaundice in neonates

dirk
Télécharger la présentation

Neonatal Jaundice SGD

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Neonatal JaundiceSGD Dr Saffiullah AP Paeds

  2. By the end of this discussion you should be able to; 1.Make a differential diagnosis of common and significant causes of jaundice in neonates 2.Differentiate between physiological and pathological jaundice including persistent jaundice in neonates 3.Organise investigations for neonates presenting with jaundice 4.Management of common and significant causes of neonatal jaundice 5.Indications and side effects of different treatment modalities of neonatal jaundice including phototherapy Learning outcomes

  3. Clinical jaundice appears at 2-3 days. • Total bilirubin rises by less than 5 mg/dl per day. • Peak bilirubin occurs at 3-5 days of age. • Peak bilirubin concentration in Full-term infant <12mg/dl • Peak bilirubin concentration in Premature infant <15mg/dl Physiologic jaundice

  4. Clinical jaundice is not resolved in 2 weeks in the term infant and in 4 weeks in the Preterm infant. • Clinical jaundice appears again after it has been resolved. • Direct(conjugated) bilirubin concentration is more than 1.5 mg/dl . Pathologic jaundice

  5. A 10 hours old baby boy born at term developed jaundice? 1.What 6 relevant things would you ask in the history? 2.What 6 relevant things would you look for in examination? 1.What 6 investigations you would order? 2.How would you plan the treatment? 3.What 2 treatment modalities would you consider? Case 1

  6. SBR 20 mainly indirect • Hb 10, wbc 8000 and platelets 300000 • Mothers blood group O Rh positive, Baby’s A Rh positive • Coombs test positive Case 2

  7. SBR 20 mainly indirect • Hb 10, wbc 8000 and platelets 300000 • Mothers blood group B Rh negative, Baby’s A Rh positive • Coombs test positive Case 3

  8. SBR 20 mainly indirect • Hb 10, wbc 8000 and platelets 300000 • Mothers blood group A Rh positive, Baby’s A Rh positive • Coombs test negative • Blood film showed spherocytes Case 4

  9. SBR 20 mainly indirect • Hb 10, wbc 20000 and platelets 300000 • Mothers blood group A Rh positive, Baby’s A Rh positive • C reative protein CRP 150 • Coombs test negative Case 5

  10. SBR 20 mainly indirect • Hb 10, wbc 8000 and platelets 300000 • Mothers blood group A Rh positive, Baby’s A Rh positive • Coombs test negative • G6PD low Case 6

  11. Increased water loss • Diarrhea • Retinal damage • Bronze baby, tanning • Mutations in DNA?  shield scrotum • Disturb of mother-infant interaction Side effects of phototherapy

  12. 4 weeks old baby girl presented with jaundice which started in the first couple of days.On examination she was jaundice and has hepatomegaly. 1.What 6 important questions would you ask from her mother to help you with diagnosis? 2.What 4 investigations would you do? Case 6

  13. SBR 20 ,19 direct, 1 indirect • Hb 15, wbc 8000 and platelets 300000 • Mothers blood group O Rh positive, Baby’s O Rh positive • Coombs test negative • Ultrasound abdomen hepatomegaly, gallbladder not visualised • HIDA scan Case 6

  14. TFT raised TSH • Urine for reducing substances • Urine culture Other differentials

  15. Thank you

More Related