![]() Photoproducts excretion: w/o conjugationTreatments continued Phototherapy Principle : photon of light Three photochemical reactions: 1). Early deliveryTreatments continuedĪfter birth 1. Free antibody test (+) judgeLaboratory tests continuedĭuring pregnancy 1. ![]() Hyperbilirubinemia : Unconjugated bilirubin level 3. PathophysiologyRed blood cell breakdownHyperbilirubinemiaJaundiceKernicterus Seizures etc.AnemiaLiver SpleenHeart, other organsHydropsġ.Jaundice : mild severe 1-2 day 24 h2.Anemia: mild severe (3-6 weeks) heart failure3.Hepato- rare commonsplenomegalyĬomplicationKernicterus: Phase 1: decreased alertnessHypotoniaPoor feeding Phase 2:Hypertonia, Retrocollis, opisthotonus Phase 3:Hypotoniaġ. Hemolytic disease of newborn continuedABO incompatibility the mother: type O the infant: type A or B Rh incompatibility the mother Rh- the infant: Rh+D,E,C,d,e,c Hemolytic disease of newbornHemolytic disease: ABO: 85.3%Rh : 14.6%MN : 0.1% Congenital metabolic diseases -1 antitrypsin deficienc圜auses of pathological jaundice continue Biliary obstruction (cholestatic jaundice) biliary atresia, common bile duct stenosis c. hemolytic diseases: ABO, Rh incompatibility b. Direct bilirubin >2mg/dl5.Jaundice recurrent Manifestations continueĬommon causes of pathological jaundice1. Appears 2-3days (>24h of age) peaks 12.9mg/dl (full term infants) >15mg/dl (preterm infants) Fades >2 weeks (term infants) >4 weeks (preterm infants)3. By serum levels : standardManifestations continue ![]() By transcutaneous measurement : used for screening3. Unconjugated bilirubin lipid-soluble bilirubin-encephalopathy kernicterusĬlinical Manifestations Jaundice appears When: at any time during the neonatal period Where: from face chest abdomen feetġ. Enterohepatic circulation The metabolic characteristics of bilirubin continuedīilirubin toxicity 1. Defective bilirubin excretion ability to bile system 4. Bilirubin conjugation: UDPGT (uridine diphosphate glucoronyl transferase) c. Bilirubin production 8.8mg/Kg/d in newborns3.8mg/Kg/d in adults 2. The metabolic characteristics of bilirubin in newborns: 1. Intestine: stercobilins -glucuronidase enterohepatic circulation Liver: uptaken : Y protein, Z protein conjugated: UDPGT excreted to the biliary system 4. Introduction continued When? in the first week of life Where? skin, mucosa and white of eye How many? blood bilirubin concentrations is 5-7mg/dl.īilirubin Metabolism:1. Introduction Jaundice is quite common (5mg/dl). Department of Pediatrics, West China Second University Hospital, Sichuan University
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |