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16-786-752
Objectives :-
Bilirubin is a yellow compound that occurs in the normal catabolic pathway that breaks
down heme in vertebrates. This catabolism is a necessary process in the body's clearance of
waste products that arise from the destruction of aged red blood cells. First the hemoglobingets
stripped of the heme molecule which thereafter passes through various processes
of porphyrin catabolism, depending on the part of the body in which the breakdown occurs.
For example, the molecules excreted in the urine differ from those in the feces. The production
of biliverdin from heme is the first major step in the catabolic pathway, after which
the enzymebiliverdin reductase performs the second step, producing bilirubin from biliverdin.
Neonatal jaundice can be seen in cases of maternal-fetal blood type incompatibility. The
mother's body will actually produce antibodies that attack the fetus's blood cells. This causes a
breakdown of the red blood cells and thus an increased release of bilirubin from the red cells.
A large scalp bruise called a cephalohematoma can occur during the birthing process. Such a
bruise is really a collection of clotted blood just beneath the skin surface. As the body naturally
breaks down this clotted blood, a large amount of bilirubin is released at once. This sudden
excess in serum bilirubin may be too much for the baby's liver to handle, and jaundice will
develop.
Sometimes a baby swallows blood during birth. This swallowed blood is broken down in the
baby's intestinesand absorbed into the bloodstream. Just as the excess blood from a blood
clot will cause a rise in serum bilirubin, so will this.
A mother who has diabetes may cause a baby to develop neonatal jaundice.
Crigler-Najjar syndrome and Lucey-Driscoll syndrome are also conditions that can cause
jaundice.
Breast-fed babies, particularly those who have difficulty nursing or getting enough nutrition
from breast-feeding, are at higher risk of jaundice. Dehydration or a low calorie intake may
contribute to the onset of jaundice.
Blood type and Rh determination in mother and infant,Direct antiglobulin test (DAT) in the
infant (direct Coombs test), Hemoglobin and hematocrit values, Serum albumin levels,
Peripheral blood film for erythrocyte morphology, reticulocyte count, conjugated bilirubin
levels, Ultrasonography and Radionuclide scanning
Exchange transfusion:-
High-pitched crying
Fever
Vomiting
Kernicterus :-
Hearing loss
Diagnosis : jaundice