Jaundice是the yellowish discoloration of the skin, mucous membranes, and the whites of the eyes (sclerae) caused by elevated levels ofbilirubinin the blood (hyperbilirubinemia). The termjaundice是derived from the French wordjaune, which means yellow.Jaundice是not technically a disease, but rather it is a visible sign of an underlying condition causing increased levels ofbilirubinin the blood.
Jaundicesymptoms in newborns includefever, fussy eating, and looking ill.
Treatment for jaundice in newborns includes phototherapy, tanning booths, and other treatments.
Neonataljaundice is the most common condition requiring medical evaluation in anewborn．Though it is often a normal and transient physiologic consequence of thenewborn's immatureliver, there are a variety of other medical conditions which can cause severeneonataljaundice. Jaundice in the newborn must be carefully monitored, as excessively elevated levels of bilirubin that go untreated for too long, can lead to permanentbrain damage(a condition termedkernicterus).
Jaundice usually appears first on the face and then moves to the chest, belly, arms, and legs as bilirubin levels get higher. The whites of the eyes can also look yellow. Jaundice can be harder to see in babies with darker skin color. The baby's doctor or nurse can test how much bilirubin is in the baby's blood.
Neonatal jaundice may be associated with various signs and symptoms, depending upon the degree of elevation in bilirubin levels as well as the exact cause of jaundice. The yellow discoloration of the skin will begin on the face and forehead and extend toward thefeetas the levels of bilirubin increase. This characteristic progression of jaundice in infants can sometimes allow your health care professional to estimate the bilirubin level based on the location and extent of jaundice, though this assessment can often be inaccurate.
The signs and symptoms associated with neonatal jaundice may include the following:
Kernicterus, which is caused by prolonged excessively elevated levels of bilirubin affecting the central nervous system, must be recognized and promptly treated as it can lead to permanent brain damage. Kernicterus is an irreversible and chronic condition that can includecerebral palsy,hearing loss, and intellectual impairment. Kernicterus has likely started to develop if the infant begins to exhibit extreme lethargy, changes in muscle tone, and a high-pitched cry.
Jaundice is caused by the accumulation of bilirubin in the blood, typically from an increased production of bilirubin or a decreased ability to metabolize and excrete it. Bilirubin is formed when红细胞break down and is normally metabolized in theliverand excreted in urine and feces.
Neonatal jaundice can be caused by several different conditions, and it is very commonly seen in newborns. The most common cause in newborns is physiologic jaundice, which affects most newborns and is usually benign. However, there are many other causes of neonatal jaundice that can be more serious, and require further medical evaluation and intervention. A newborn that develops jaundice within the first 24 hours of life requires immediate medical attention. The following are some of the causes of neonatal jaundice.
Jaundice in newborns most commonly occurs because their livers are not mature enough to remove bilirubin from the blood. Jaundice may also be caused by a number of other medical conditions, for example, physiologic jaundice, neonatal jaundice,hemolysis,polycythemia, cephalohematoma, the infant swallowing during birth, mothers who havediabetes, and Crigler-Najjar syndrome and Lucey-Driscoll syndrome, maternal-fetal blood group incompatibility (Rh, ABO),breast milkandbreastfeeding, a collection of blood under thescalp, and red blood cell enzyme and membrane defects.
This form of jaundice is usually evident on the second or third day of life. It is the most common cause ofnewborn jaundiceand it is usually a transient and harmless condition. Physiologic jaundice is caused by the inability of the newborn's immature liver to metabolize (conjugate) and thus excrete bilirubin, which accumulates due to the breakdown of红细胞which have a shorter life-span (70 to 90 days) than adult red blood cells (120 days). This increase in red blood cell breakdown and decreased ability to metabolize bilirubin overwhelms the newborns ability to properly process and excrete bilirubin. As the newborn's liver matures, however, the jaundice eventually disappears after 1 to 2 weeks.
More Health News »This form of jaundice occurs when there is incompatibility between theblood typesof the mother and the fetus. This leads to increased bilirubin levels from the breakdown of the fetus' red blood cells (hemolysis).
This form of jaundice occurs inbreastfednewborns and often appears at the end of the first week of life. Certain chemicals inbreast milkare thought to be responsible. It is usually a harmless condition that resolves spontaneously. Mothers typically do not have to discontinuebreastfeeding．
This form of jaundice occurs when thebreastfednewborn does NOT receive adequate breast milk intake. This may occur because of delayed or insufficient milk production by the mother or because of poor feeding by the newborn. This inadequate intake results indehydrationand fewer bowel movements for the newborn, which results in decreased bilirubin excretion from the body.
Sometimes during the birthing process, the newborn may sustain a bruise or injury to the head, resulting in a blood collection/blood clotunder thescalp．As this blood is naturally broken down, sudden elevated levels of bilirubin may overwhelm the processing capability of the newborn's immature liver, resulting in jaundice.
Inheritedgenetic enzyme disorders, such as glucose-6-phosphate dehydrogenase deficiency (G6PD deficiency) or pyruvate kinase deficiency, for example, can lead to increased hemolysis and subsequent elevation in bilirubin levels.
Abnormalities in the membrane and shape of red blood cells (for example, spherocytosis) can lead to increased hemolysis.
Other causes of neonatal jaundice include prematurity, maternaldiabetes,polycythemia, infection/sepsis,hypothyroidism, biliary atresia,cystic fibrosis, Crigler-Najjar syndrome,Gilbert syndrome,hepatitis,thalassemia, and galactosemia.
Approximately 60% of all newborns develop jaundice; however newborns with certain risk factors are at higher risk for developing neonatal jaundice. Risks factors include the following:
Neonatal jaundice can be diagnosed by examining the newborn and obtaining a blood test to check the total serum bilirubin level. Your health care professional should closely follow your newborn for the development of jaundice, and many hospitals routinely check total bilirubin levels on newborns prior to hospital discharge. Though the blood test is the most accurate, in certain instances, a transcutaneous bilirubin reading can be obtained by placing a handheld sensor against the newborn's skin. If this reading is high, a blood test may be ordered to confirm the total bilirubin level. Bilirubin levels are usually highest at 3-5 days of life. Additional blood tests may be ordered for those newborns who require treatment and monitoring, or for those who may have other underlying conditions thought to be causing neonatal jaundice.
The need to treat jaundice in newborns is determined by interpreting the total bilirubin level in relation to the newborn's age in hours. If the level is deemed to be too high, or if it is rising too quickly, treatment is necessary. Sometimes, all that is needed for treatment is close monitoring of the bilirubin levels, and no further interventions may be necessary. In certain instances, treatment for neonatal jaundice can occur at home, while in other cases, admission to a hospital is necessary.
基于总胆红素水平,底层cause leading to jaundice, and the newborn's clinical condition, various treatment modalities are available to treat jaundice in newborns. These include the following:
The complications associated with neonatal jaundice occur when bilirubin levels reach toxic levels, and the bilirubin gets into the central nervous system and damages the brain. The brain toxicity can either be reversible (early acute bilirubinencephalopathy) or the damage may be permanent and irreversible (kernicterus). Permanent damage may lead tocerebral palsy, deafness, and intellectual impairment.
Generally speaking, the prognosis for newborns with jaundice is excellent if they receive the appropriate monitoring and treatment, and the vast majority of infants with neonatal jaundice will improve with no adverse effects. However, health care professionals need to remain vigilant and parents need be informed and educated about the potential dangers of severe hyperbilirubinemia in order to prevent the devastating consequences of kernicterus.
Some degree of jaundice in newborns is normal and not entirely preventable. However, thepreventionof significant hyperbilirubinemia and its complications is possible through proper screening (obtaining bilirubin levels), identifying newborns at high risk, close surveillance, and monitoring of those infants with hyperbilirubinemia, parent education, and prompt treatment when deemed medically indicated.
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In addition, each person's blood is either Rh-positive or Rh-negative. It is important to know what to expect before, during, and after a blood transfusion, and the risks, side effecs, or complications of blood transfusions.
Encephalopathy means brain disease, damage, or malfunction. Causes of encephalopathy are varied and numerous. The main symptom of encephalopathy is an altered mental state. Other symptoms include:
Treatment of encephalopathy depends on the type of encephalopathy (anoxia, diabetic, Hashimoto's, hepatic, hyper - hypotensive, infectious, metabolic, infections, uremic, or Wernicke's) are examples of types of encephalopathy.
