Causes and risk factors:
Jaundice is caused due to increased levels of bilirubin in the blood. Usually the bilirubin is filtered from the liver into the intestine, however in some new born babies as the liver is still immature the filtration is not quick enough causing raised levels of bilirubin in the blood. Most of the babies develop this jaundice during their first week. It is called as physiological jaundice. Jaundice can also occur due to some underlying pathology like bacterial or viral infection, malfunctioning of the liver or an enzyme deficiency. Incompatibility between the mother and babies blood group is one of the common cause of jaundice. Sepsis and hemorrhages are certain other contributing factors. Jaundice caused due to these pathologies is called as pathological jaundice in neonates.
Clinical presentations:
As the name suggests the baby presents with yellowish discoloration of the skin and sclera. Initially involvement of the face is seen later it spreads to the body. Palms and soles appear yellow. The symptoms are seen 2 to 4 days after birth. Pressing of the forehead or fingers causes the skin to become yellow. The baby becomes dull and sleepy. Difficulty in feeding is experienced by mother. In severe cases permanent damage of nerves can occur leading to kernicterus.
Diagnosis and investigations:
Diagnosis is done on the basis of signs noted by the mother and the examination carried out by the doctor. A simple skin test using a transcutenous bilirubinometer device is carried out. Serum bilirubin levels are measured. Other investigations which can be done are complete blood count and urine routine.
Treatment:
The treatment plan depends upon the severity of symptoms. In mild cases without any medical intervention recovery occurs within a week or two. Adequate feeding is essential. In severe cases hospitalization and close monitoring is required. Phototherapy is the standard measures of treatment adopted. In cases of jaundice due to incompatible blood group intravenous transfusion of immunoglobulin is done.
