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Neonatal Jaundice

Year 2018, Volume: 10 Issue: 4, 0 - 0, 25.07.2018

Abstract

Abstract

Almost two thirds of newborn experience jaundice in the first week of life. Untreated high bilirubin levels which are not diagnosed timely may lead to bilirubin encephalopathy and severe neurologic sequaela. Pathologic jaundice is defined as a bilirubin level above the 95th percentile in infants larger than 35 gestational weeks. Main goal oftreatment in these infants is to prevent severe hyperbilirubinemia and bilirubin encephalopathy. Sufficient and successful breastfeeding is essential. Parents should be informed about appropriate feeding methods and about jaundice. Bilirubin levels are evaluated by the bilirubin nomogram according to the age of the infant. Direct hyperbilirubi-nemia in the newborn period is always pathologic. In every clinical visit after discharge from the hospital, the weight of the infant, percentage of weight loss, nutritional status, frequency, color and amount of urine and stools and presence of jaundice should beinvestigated. Prolonged jaundice is defined as jaundice persisting longer than 2 weeksin term infants and longer than 3 weeks in preterm infants. Breast feeding jaundice should be a consideration. Phototherapy is the method of treatment in most cases

References

  • Kaynaklar 1.Hansen TWH, Bratlid D. Physiology of neonatal unconjugated hyper-bilirubinemia. In: Stevenson DK, Maisels MJ, Watchko JF, eds. Care ofJaundiced Neonate. New York: McGraw-Hill, 2012: 65-95. 2.Schwarz HP, Haberman BE, Ruddy RM. Hyperbilirubinemia. Current gui-delines and emerging therapies. Pediatr Emer Care 2011; 27: 884- 889. 3.Kaplan M, Muraca M, Hammerman C, et al. Inbalance between produc-tion and conjugation of bilirubin: a fundamental concept in the mecha-nism of neonatal jaundice. Pediatrics 2002; 110: e47 4.American Academy of Pediatrics Subcommittee on Hyperbilirubinemia.Management of hyperbilirubinemia in the newborn infant 35 or more we-eks of gestation. Pediatrics. 2004;114(1):297. 5.Johnson L, Brown AK, Bhutani VK. BIND-a clinical score for bilirubininduced neurologic dysfunction in newborns. Pediatrics Suppl 1999; 104:746-747. 6.Shapiro SM. Definition of the clinical spectrum of kernicterus and biliru-bin induced neurologic dysfunction (BIND). J Perinatol 2005; 25: 54-59. 7.Volpe JJ. Neurology of the Newborn, 4th Edition. Philadephia: WB Sa-unders, 2001 8.Stevenson DK, Fanarof AA, Maisels MJ, et al. Prediction of hyperbilirubi-nemia in near-term and term infants. Pediatrics 2001; 108: 31-39. 9.American Academy of Pediatrics, Provisional Committee for Quality Im-provement. Practice parameter: mamagement of hyperbilirubinemia inthe healty term newborn. Pediatrics 1994; 94: 558-565. 10.Sarıcı SU, Serdar MA, Korkmaz A, et al. Incidence, course, and predic-tion of hyperbilirubinemia in near-term and term newborns. Pediatrics2004; 113: 775-780. 11.Tiker F, Gulcan H, Kilicdag H, Tarcan A, Gurakan B. Extreme hyper-bilirubinemia in newborn infants. Clin Pediatr (Phila). 2006; 45: 257-261. 12.Şenol V, Ünalan D, Çetinkaya F, Öztürk Y. Kayseri ilinde halk ebeliğiile ilgili geleneksel uygulamalar. Klinik Gelişim 2004; 17 (3/4): 47-55. 13.Türk Neonatoloji Derneği. Yenidoğan Sarılıklarına Yaklaşım, İzlem VeTedavi Rehberi, 2014. 14.De Carvalho M, Holl M, Harvey D. Effects of water supplementation onphysiological jaundice in breast-fed babies. Arch Dis Child 1981; 56:568–569. 15.Nicoll A, Ginsburg R, Tripp JH. Supplementary feeding and jaundice innewborns. Acta Paediatr Scand. 1982; 71: 759–761. 16.Maisels MJ, Bhutani VK, Bogen D Newman TB, Stark AR, Watchko JF.Hyperbilirubinemia in the newborn infant ≥35 weeks gestation: an up-date with clarification. Pediatrics 2009; 124: 1193-1198. 17.Kaplan M, Merlob P, Regev R. Israel guidelines for the management ofneonatal hyperbilirubinemia and prevention of kernicterus. J Perinatol2008; 28: 389-397 18.Hannam S, McDonnell M, Rennie JM. Investigation of prolonged neo-natal jaundice. Acta Paediatr 2000; 89: 694-697. 19.Lawrence M. Gartner, MD. Breastfeeding and jaundice.J Perinatol.2011;21: 21-25 20.Wong RJ, DeSandre GH, Sibley E, Stevenson DK. Neonatal jaundice andliver disease. In: Fanaroff AA, Martin RJ (eds). Neonatal-Perinatal Me-dicine Disease of the Fetus and Infant. 2006;8(1):1419-1466. 21.Gartner LM. Neonatal jaundice. Pediatr Rev. 1994;15:422. 22.Sarici SU, Saldir M. Genetic factors in neonatal hyperbilirubinemia andkernicterus. Turk J Pediatr. 2007;49:245-249 23.McKiernan PJ. Neonatal cholestasis. Semin Neonatol. 2002:7;153-157.

Yenidoğan Sarılığı

Year 2018, Volume: 10 Issue: 4, 0 - 0, 25.07.2018

Abstract

Öz

Yenidoğanların en az üçte ikisinde yaşamın ilk haftasında klinik olarak sarılık görülür. Zamanında tanı konup tedavi edilmeyen yüksek bilirubin düzeyleri bilirubin ensefalopatisi ve ciddi nörolojik sekellere neden olur. Patolojik sarılık, gebelik haftası 35 veüzerindeki bebeklerde STB değerinin bilirubin nomogramında %95 persentil ve üzerinde olması ile tanımlanır. Bu nedenle yenidoğan sarılığı izleminde ana amaç ağır hiperbilirubinemi gelişimini ve bilirubin ensefalopatisini önlemektir. Yeterli ve başarılı emzirme elzemdir. aileler uygun beslenme ve sarılık konusunda bilgilendirilmelidir. Bilirubin  düzeyleri bebeğin yaşına göre bilirubin nomogramında yorumlanmalıdır. Yenidoğan döneminde Direkt hiperbilirubinemi her zaman patolojiktir. Taburculuk sonrasıher kontrolde yenidoğanın ağırlığı, ağırlık kaybı yüzdesi, beslenmesi yanında idrar, gaita sayı ve rengi, sarılık olup olmadığı değerlendirilmelidir. Term bebeklerde iki haftadan, preterm bebeklerde üç haftadan uzun süren sarılıklar uzamış sarılık olarak tanımlanır. Anne sütü sarılığına dikkat etmek gerekir. Tedavide sıklıkla fototerapi kullanılır.

References

  • Kaynaklar 1.Hansen TWH, Bratlid D. Physiology of neonatal unconjugated hyper-bilirubinemia. In: Stevenson DK, Maisels MJ, Watchko JF, eds. Care ofJaundiced Neonate. New York: McGraw-Hill, 2012: 65-95. 2.Schwarz HP, Haberman BE, Ruddy RM. Hyperbilirubinemia. Current gui-delines and emerging therapies. Pediatr Emer Care 2011; 27: 884- 889. 3.Kaplan M, Muraca M, Hammerman C, et al. Inbalance between produc-tion and conjugation of bilirubin: a fundamental concept in the mecha-nism of neonatal jaundice. Pediatrics 2002; 110: e47 4.American Academy of Pediatrics Subcommittee on Hyperbilirubinemia.Management of hyperbilirubinemia in the newborn infant 35 or more we-eks of gestation. Pediatrics. 2004;114(1):297. 5.Johnson L, Brown AK, Bhutani VK. BIND-a clinical score for bilirubininduced neurologic dysfunction in newborns. Pediatrics Suppl 1999; 104:746-747. 6.Shapiro SM. Definition of the clinical spectrum of kernicterus and biliru-bin induced neurologic dysfunction (BIND). J Perinatol 2005; 25: 54-59. 7.Volpe JJ. Neurology of the Newborn, 4th Edition. Philadephia: WB Sa-unders, 2001 8.Stevenson DK, Fanarof AA, Maisels MJ, et al. Prediction of hyperbilirubi-nemia in near-term and term infants. Pediatrics 2001; 108: 31-39. 9.American Academy of Pediatrics, Provisional Committee for Quality Im-provement. Practice parameter: mamagement of hyperbilirubinemia inthe healty term newborn. Pediatrics 1994; 94: 558-565. 10.Sarıcı SU, Serdar MA, Korkmaz A, et al. Incidence, course, and predic-tion of hyperbilirubinemia in near-term and term newborns. Pediatrics2004; 113: 775-780. 11.Tiker F, Gulcan H, Kilicdag H, Tarcan A, Gurakan B. Extreme hyper-bilirubinemia in newborn infants. Clin Pediatr (Phila). 2006; 45: 257-261. 12.Şenol V, Ünalan D, Çetinkaya F, Öztürk Y. Kayseri ilinde halk ebeliğiile ilgili geleneksel uygulamalar. Klinik Gelişim 2004; 17 (3/4): 47-55. 13.Türk Neonatoloji Derneği. Yenidoğan Sarılıklarına Yaklaşım, İzlem VeTedavi Rehberi, 2014. 14.De Carvalho M, Holl M, Harvey D. Effects of water supplementation onphysiological jaundice in breast-fed babies. Arch Dis Child 1981; 56:568–569. 15.Nicoll A, Ginsburg R, Tripp JH. Supplementary feeding and jaundice innewborns. Acta Paediatr Scand. 1982; 71: 759–761. 16.Maisels MJ, Bhutani VK, Bogen D Newman TB, Stark AR, Watchko JF.Hyperbilirubinemia in the newborn infant ≥35 weeks gestation: an up-date with clarification. Pediatrics 2009; 124: 1193-1198. 17.Kaplan M, Merlob P, Regev R. Israel guidelines for the management ofneonatal hyperbilirubinemia and prevention of kernicterus. J Perinatol2008; 28: 389-397 18.Hannam S, McDonnell M, Rennie JM. Investigation of prolonged neo-natal jaundice. Acta Paediatr 2000; 89: 694-697. 19.Lawrence M. Gartner, MD. Breastfeeding and jaundice.J Perinatol.2011;21: 21-25 20.Wong RJ, DeSandre GH, Sibley E, Stevenson DK. Neonatal jaundice andliver disease. In: Fanaroff AA, Martin RJ (eds). Neonatal-Perinatal Me-dicine Disease of the Fetus and Infant. 2006;8(1):1419-1466. 21.Gartner LM. Neonatal jaundice. Pediatr Rev. 1994;15:422. 22.Sarici SU, Saldir M. Genetic factors in neonatal hyperbilirubinemia andkernicterus. Turk J Pediatr. 2007;49:245-249 23.McKiernan PJ. Neonatal cholestasis. Semin Neonatol. 2002:7;153-157.
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Details

Primary Language Turkish
Subjects ​Internal Diseases
Journal Section makaleler
Authors

Nuran Üstün

Publication Date July 25, 2018
Published in Issue Year 2018 Volume: 10 Issue: 4

Cite

APA Üstün, N. (2018). Yenidoğan Sarılığı. Klinik Tıp Aile Hekimliği, 10(4).
AMA Üstün N. Yenidoğan Sarılığı. Aile Hekimliği. July 2018;10(4).
Chicago Üstün, Nuran. “Yenidoğan Sarılığı”. Klinik Tıp Aile Hekimliği 10, no. 4 (July 2018).
EndNote Üstün N (July 1, 2018) Yenidoğan Sarılığı. Klinik Tıp Aile Hekimliği 10 4
IEEE N. Üstün, “Yenidoğan Sarılığı”, Aile Hekimliği, vol. 10, no. 4, 2018.
ISNAD Üstün, Nuran. “Yenidoğan Sarılığı”. Klinik Tıp Aile Hekimliği 10/4 (July 2018).
JAMA Üstün N. Yenidoğan Sarılığı. Aile Hekimliği. 2018;10.
MLA Üstün, Nuran. “Yenidoğan Sarılığı”. Klinik Tıp Aile Hekimliği, vol. 10, no. 4, 2018.
Vancouver Üstün N. Yenidoğan Sarılığı. Aile Hekimliği. 2018;10(4).