A GP�s guide to neonatal jaundice[1]

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By: imnopqrst (23 month(s) ago)

Dear Samir kindly send me your presentation if possible. Regards. Dr Tariq, Pakistan chemtariq@yahoo.com

By: imnopqrst (23 month(s) ago)

Dear Samir kindly send me your presentation if possible. Regards. Dr Tariq, Pakistan chemtariq@yahoo.com

By: imnopqrst (23 month(s) ago)

Dear Samir kindly send me your presentation to me if possible. Regars. Dr Tariq, Pakistan chemtariq@yahoo.com

Presentation Transcript

A GP’s guide to neonatal jaundice : 

A GP’s guide to neonatal jaundice Samir Dawlatly August 2009

Some terms : 

Some terms Physiological jaundice Changeover to neonatal bilirubin metabolism Prolonged jaundice Beyond day 10 in term babies (day 14 in preterm) Abnormal early jaundice Within 24 hours of birth – haemolysis/infection

Physiological jaundice : 

Physiological jaundice Immature liver Worsened by Prematurity Excess RBC breakdown Baby clinically well Has resolved by Day 10 in term babies (day 14 in preterm) May be sign of infection or galactosaemia

Prolonged jaundice : 

Prolonged jaundice May be sign of underlying disease Infection (congenital/acquired) Delayed metabolism Hepatitis (infection/atresia/metabolic disorder) Haemolytic disease

First Day Jaundice (in case they escape, or home birth) : 

First Day Jaundice (in case they escape, or home birth) Haemolysis needs to be excluded ABO incompatibility Rhesus incompatibility Red cell anomalies

What does a GP need to know : 

What does a GP need to know When to refer What to tell parents Picking up the pieces

When to refer… : 

When to refer… Day 1 jaundice Jaundice and features of being unwell – lethargy, poor feeding Prolonged jaundice But all this is likely to be picked up by community midwife and/or health visitor

What parents should expect : 

What parents should expect Tests that babies may have to undergo include: Blood tests (Coomb’s, FBC, chemistry, culture) Urine (usually catheter) Possible treatments Phototherapy and ivi Exchange transfusions IV antibiotics

Picking up the pieces : 

Picking up the pieces Extended stay in hospital for baby – possible delay in bonding Traumatic nature of tests Coping with potential new diagnosis May need explanations not fully received in hospital

Resources : 

Resources Barrett, Lander and Diwakar, 2003. A Paediatric Vade Mecum (14th ed). Edward Arnold Publishers, London.