1 / 12

NEONATAL JAUNDICE

NEONATAL JAUNDICE. BY DR BLESSING OFEJIRO OKPERI B.Med.Sc.(Hons), MBBS, FWACP (Paed) SENIOR LECTURER / CONSULTANT PAEDIATRICIAN H.O.D, DEPT OF PAEDIATRICS, DELSU & DELSUTH . MEDICAL DIRECTOR

osmond
Download Presentation

NEONATAL JAUNDICE

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. NEONATAL JAUNDICE BY DR BLESSING OFEJIRO OKPERI B.Med.Sc.(Hons), MBBS, FWACP (Paed) SENIOR LECTURER / CONSULTANT PAEDIATRICIAN H.O.D, DEPT OF PAEDIATRICS, DELSU & DELSUTH. MEDICAL DIRECTOR RAPHA SPECIALIST CHILDREN & GENERAL CLINIC, 85 AIRPORT ROAD, EFFURUN.

  2. PRE - TEST • What the causes jaundice in neonates? • How is jaundice diagnosed? • What is physiologic jaundice? • Which of the following is useful for Rx : • Early morning sunlight (b) Glucose + Ampiclox (c ) Phenobarbitone

  3. LEARNING OBJECTIVES • DEFINE JAUNDICE • PATHOPHYSIOLOGY OF JAUNDICE • DANGER OF JAUNDICE • DEBUNKING WRONG TREATMENTS • EMPHASIZING PROMPT & EFFECTIVE TREATMENT

  4. DEFINITION PREVALENCE BURDEN OF THE DISEASE INTRODUCTION

  5. BILIRUBIN METABOLISM • SOURCES OF BILIRUBIN • HEMOLYSIS • BILIRUBIN BINDING TO ALBUMIN • LIVER UPTAKE • BINDING TO LIGADIN Y & Z • CONJUGATION WITH UDPGT • EXCRETION INTO BILE • ENTEROHEPATIC CIRCULATION

  6. PHYSIOLOGIC JAUNDICE • DEFINITION • CAUSES • - RBC VOL ,RBC SURVIVAL,ELB,EHC • -DEFECTIVE UPTAKE • -DEFECTIVE CONJUGATION • -REDUCED EXCRETION • RATE OF RISE AND PEAK

  7. PATHOLOGIC JAUNDICE • DEFINITION • CAUSES • -POLYCYTHAEMIA • -HEMOLYSIS • -BILIRUBIN DISPLACEMENT • -HEPATOBILIARY DISEASES • RATE OF RISE AND PEAK

  8. BILIRUBIN TOXICITY • PATHOLOGY: UNCOUPLING OF OXIDATIVE PHOSPHORILATION, NEURONAL CELL DEATH • WORSE HIT:BASALGANGLIA,GLOBUS PALLIDUS,PUTAMEN,CAUDATE NUCLEI • + CH, BULBAR & CEREBELLAR NUCLEI

  9. CLINICAL STAGING 1.POOR MORO,HYPOTONIA,LETHARGY POOR FEEDING, HIGH PITCH CRY 2.OPISTHOTONUS,HYPERTONIA,FEVER SEIZURES,ROWING “BICYCLING” PARALYSIS OF UPWARD GAZE 3.APPARENT RECOVERY 4.LATE SEQUELAE: SPASTICITY,ATHETOSIS COMPLETE OR PARTIAL DEAFNESS, CP, MR

  10. CLINICAL EVALUATION • VISUAL ESTIMATION(ROUGH GUIDE) • SB (TOTAL & CONJUGATED) • PCV & COOMBS • CONJ BIL < 2mg% VERSUS > 2mg % • PCV HIGH VS NORMAL OR LOW • RETIC NORMAL VS ABNORMAL

  11. TREATMENT • PHOTOTHERAPY:INDICATIONS,MOA LIGHT SOURCE, TECHNIQUE, PHOTO BLANKET • EBT; INDICATIONS,MOA, TECHNIQUE • PHENOBARBITONE: MOA, DEMERITS CONTEMPORARY INDICATIONS • ACTIVATED CHARCOL • TIN PROTOPORPHYRIN

  12. CONCLUSION • NO ROASTING OF BABY IN THE SUN • NO AMPICLOX AND GLUCOSE • NO DELAY TO REFER BABY • STOP CEREBRAL PALSY PLEASE!!!!!

More Related