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[5] [6] Quick and accurate treatment of neonatal jaundice helps to reduce the risk of neonates developing kernicterus. [7] Infants with kernicterus may have a fever [8] or seizures. [9] High pitched crying is an effect of kernicterus. [citation needed] Exchange transfusions performed to lower high bilirubin levels are an aggressive treatment. [10]
While neonatal cholestasis refers to conjugated hyperbilirubinemia in newborn infants, there are many pathologic processes that can cause this to occur. Any anatomic disturbance or obstruction in the hepatobiliary tract can cause elevated levels of conjugated bilirubin. [1] Some of the causes of neonatal cholestasis are listed below:
Infant undergoing bili light therapy in a United States maternity ward. A bili light [1] [2] is a light therapy tool to treat newborn jaundice (hyperbilirubinemia).High levels of bilirubin can cause brain damage (kernicterus), leading to cerebral palsy, auditory neuropathy, gaze abnormalities and dental enamel hypoplasia.
Isoimmunization occurs when the maternal immune system is sensitized to red blood cell surface antigens. The most common causes of isoimmunization are blood transfusion, and fetal-maternal hemorrhage. [12] The hemolytic process can result in anemia, hyperbilirubinemia, neonatal thrombocytopenia, and neonatal neutropenia. [6]
A red cell exchange transfusion is usually given to treat severe hyperbilirubinemia or anemia in babies with hemolytic disease of the newborn. It removes neonatal red cells coated with maternal antibody and reduces the level of bilirubin. A ‘double volume exchange’ (160–200 ml/kg) removes around 90% of neonatal red cells and 50% of ...
Newborn infant with Rhesus disease, a type of hemolytic disease of the newborn, suffering from hydrops fetalis (edema caused by heart failure). The infant did not survive. [4] Signs of hemolytic disease of the newborn include a positive direct Coombs test (also called direct agglutination test), elevated cord bilirubin levels, and hemolytic anemia.
As high biliverdin levels are usually related to bilirubinemia, tin mesoporphyrin has been found to aid in treatment and prevention of this, primarily in newborn infants. Tin mesoporphyrin competitively inhibits the heme oxygenase enzyme, which prevents the breakdown of heme to biliverdin leading to accumulation of heme and not bilirubin. [6]
Bilirubin should be tested from cord blood. [5] Ferritin - because most infants affected by HDN have iron overload, ferritin levels must be measured before giving the infant any additional iron. [11] Newborn Screening Tests - Transfusion with donor blood during pregnancy or shortly after birth can affect the results of the Newborn Screening Tests.