Question

A full term female neonate was born to a 21-year-old woman. The baby was found to have icterus at 4 hr. after birth. Upon noticing this, several laboratory tests were ordered. Laboratory Test Results: The neonate’s red cells typed B, Rh+, while the mother’s red cells typed O, Rh=. A blood smear showed changes typical of hemolysis. A screen for fetomaternal hemorrhage was negative. The baby’s G6PD activity was normal. Sickle cell test had negative results. An infectious disease evaluation was completed reported as negative. Day 1 Serum Bilirubin was 10mg/dl. Day 2 Bilirubin was 12 mg/dl Explain fully the following questions: What is the diagnosis of the neonate’s condition? What is the treatment for this condition? What needs to be done for the mother?

Answer 1

ANS) The diagnosis of the neonate's condition is the 'Neonatal Jaundice'.

The neonatal jaundice is a kind of disease which makes the yellowish discoloration of the white portion of eyes and dermis in a infant baby because of high range of bilirubin.And some of the other signs are sleeping for a long time or the poor feeding.And some of other problems involve seizures and the cerebral palsy etc....

In some of the other cases the jaundice can occurs from the breakdown of RBC(Red Blood Cell),liver disorders,hypothyroidism or the metabolic diseases.The range of bilirubin more than 2 mg/dL may be seen.Or in the case of healthy newborn babies,the jaundice can occur if the range is more than 18 mg/dL. Mainly the jaundice is seen in initial day of baby,there is a sudden increase in levels and the jaundice will be continuing for greater than 2 weeks.

The requirement of treatment is based on bilirubin ranges,age of the newborn and the fundamental reasons of disease.The treatments involve more repeated feeding,phototherapy or exchange transfusion.In the case of newborn babies most assertive treatment is needed.The physiologic jaundice mainly survive at least for 7 days.This disease condition mainly occurs in around 50 percentage of the new born babies and in the case of early born child's,there is a chance of 80 percentage for this condition.

If in case the neonatal jaundice,the photo therapy didn't cure the disease then other reasons like the biliary atresia,bile duct paucity,Alagille syndrome ,alpha 1-antitrypsin deficiency must be considered.

In the phototherapy treatment,the altering of trans-bilirubin into water-soluble cis-bilirubin isomer is done.In this therapy a particular frequency of blue light is used and during the therapy,the eyes of baby will be closed.

The exchange transfusion is mush happen on the basis of health rank and age of the newborn.This should be dome in case if the bilirubin range of the newborn is greater than 25 mg/dL.

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