Abstract
Abstract
Almost two thirds of newborn experience jaundice in the first week of life. Untreated high bilirubin levels which are not diagnosed timely may lead to bilirubin encephalopathy and severe neurologic sequaela. Pathologic jaundice is defined as a bilirubin level above the 95th percentile in infants larger than 35 gestational weeks. Main goal of treatment in these infants is to prevent severe hyperbilirubinemia and bilirubin encephalopathy. Sufficient and successful breastfeeding is essential. Parents should be informed about appropriate feeding methods and about jaundice. Bilirubin levels are evaluated by the bilirubin nomogram according to the age of the infant. Direct hyperbilirubinemia in the newborn period is always pathologic. In every clinical visit after discharge from the hospital, the weight of the infant, percentage of weight loss, nutritional status, frequency, color and amount of urine and stools and presence of jaundice should be investigated. Prolonged jaundice is defined as jaundice persisting longer than 2 weeks in term infants and longer than 3 weeks in preterm infants. Breast feeding jaundice should be a consideration. Phototherapy is the method of treatment in most cases.
References
- Kaynaklar 1.Hansen TWH, Bratlid D. Physiology of neonatal unconjugated hyperbiliru-binemia. In: Stevenson DK, Maisels MJ, Watchko JF, eds. Care of Jaundi-ced Neonate. New York: McGraw-Hill, 2012: 65-95. 2.Schwarz HP, Haberman BE, Ruddy RM. Hyperbilirubinemia. Current gui-delines and emerging therapies. Pediatr Emer Care 2011; 27: 884- 889. 3.Kaplan M, Muraca M, Hammerman C, et al. Inbalance between producti-on and conjugation of bilirubin: a fundamental concept in the mechanism ofneonatal jaundice. Pediatrics 2002; 110: e47 4.American Academy of Pediatrics Subcommittee on Hyperbilirubinemia. Ma-nagement of hyperbilirubinemia in the newborn infant 35 or more weeks ofgestation. Pediatrics. 2004;114(1):297. 5.Johnson L, Brown AK, Bhutani VK. BIND-a clinical score for bilirubin inducedneurologic dysfunction in newborns. Pediatrics Suppl 1999; 104: 746-747. 6.Shapiro SM. Definition of the clinical spectrum of kernicterus and bilirubininduced neurologic dysfunction (BIND). J Perinatol 2005; 25: 54-59. 7.Volpe JJ. Neurology of the Newborn, 4th Edition. Philadephia: WB Saunders, 2001 8.Stevenson DK, Fanarof AA, Maisels MJ, et al. Prediction of hyperbilirubine-mia in near-term and term infants. Pediatrics 2001; 108: 31-39. 9.American Academy of Pediatrics, Provisional Committee for Quality Impro-vement. Practice parameter: mamagement of hyperbilirubinemia in the he-alty term newborn. Pediatrics 1994; 94: 558-565. 10.Sarıcı SU, Serdar MA, Korkmaz A, et al. Incidence, course, and predictionof hyperbilirubinemia in near-term and term newborns. Pediatrics 2004; 113:775-780. 11.Tiker F, Gulcan H, Kilicdag H, Tarcan A, Gurakan B. Extreme hyperbiliru-binemia in newborn infants. Clin Pediatr (Phila). 2006; 45: 257-261. 12.Şenol V, Ünalan D, Çetinkaya F, Öztürk Y. Kayseri ilinde halk ebeliği ile il-gili geleneksel uygulamalar. Klinik Gelişim 2004; 17 (3/4): 47-55. 13.Türk Neonatoloji Derneği. Yenidoğan Sarılıklarına Yaklaşım, İzlem Ve Teda-vi Rehberi, 2014. 14.De Carvalho M, Holl M, Harvey D. Effects of water supplementation on physio-logical jaundice in breast-fed babies. Arch Dis Child 1981; 56: 568–569. 15.Nicoll A, Ginsburg R, Tripp JH. Supplementary feeding and jaundice in new-borns. Acta Paediatr Scand. 1982; 71: 759–761. 16.Maisels MJ, Bhutani VK, Bogen D Newman TB, Stark AR, Watchko JF. Hyper-bilirubinemia in the newborn infant ≥35 weeks gestation: an update with cla-rification. Pediatrics 2009; 124: 1193-1198. 17.Kaplan M, Merlob P, Regev R. Israel guidelines for the management of neonatal hyper-bilirubinemia and prevention of kernicterus. J Perinatol 2008; 28: 389-397 18.Hannam S, McDonnell M, Rennie JM. Investigation of prolonged neonataljaundice. Acta Paediatr 2000; 89: 694-697. 19.Lawrence M. Gartner, MD. Breastfeeding and jaundice.J Perinatol. 2011;21:21-25 20.Wong RJ, DeSandre GH, Sibley E, Stevenson DK. Neonatal jaundice and li-ver disease. In: Fanaroff AA, Martin RJ (eds). Neonatal-Perinatal Medici-ne Disease of the Fetus and Infant. 2006;8(1):1419-1466. 21.Gartner LM. Neonatal jaundice. Pediatr Rev. 1994;15:422. 22.Sarici SU, Saldir M. Genetic factors in neonatal hyperbilirubinemia and ker-nicterus. Turk J Pediatr. 2007;49:245-249 23.McKiernan PJ. Neonatal cholestasis. Semin Neonatol. 2002:7;153-157.
Abstract
Öz
Yenidoğanların en az üçte ikisinde yaşamın ilk haftasında klinik olarak sarılık görülür. Zamanında tanı konup tedavi edilmeyen yüksek bilirubin düzeyleri bilirubin ensefalopatisi ve ciddi nörolojik sekellere neden olur. Patolojik sarılık, gebelik haftası 35 ve üzerindeki bebeklerde STB değerinin bilirubin nomogramında %95 persentil ve üzerinde olması ile tanımlanır. Bu nedenle yenidoğan sarılığı izleminde ana amaç ağır hiperbilirubinemi gelişimini ve bilirubin ensefalopatisini önlemektir. Yeterli ve başarılı em-zirme elzemdir. aileler uygun beslenme ve sarılık konusunda bilgilendirilmelidir. Bilirubin düzeyleri bebeğin yaşına göre bilirubin nomogramında yorumlanmalıdır. Yenidoğan döneminde Direkt hiperbilirubinemi her zaman patolojiktir. Taburculuk sonrasıher kontrolde yenidoğanın ağırlığı, ağırlık kaybı yüzdesi, beslenmesi yanında idrar, gaita sayı ve rengi, sarılık olup olmadığı değerlendirilmelidir. Term bebeklerde iki haftadan, preterm bebeklerde üç haftadan uzun süren sarılıklar uzamış sarılık olarak tanımlanır. Anne sütü sarılığına dikkat etmek gerekir. Tedavide sıklıkla fototerapi kullanılır.
References
- Kaynaklar 1.Hansen TWH, Bratlid D. Physiology of neonatal unconjugated hyperbiliru-binemia. In: Stevenson DK, Maisels MJ, Watchko JF, eds. Care of Jaundi-ced Neonate. New York: McGraw-Hill, 2012: 65-95. 2.Schwarz HP, Haberman BE, Ruddy RM. Hyperbilirubinemia. Current gui-delines and emerging therapies. Pediatr Emer Care 2011; 27: 884- 889. 3.Kaplan M, Muraca M, Hammerman C, et al. Inbalance between producti-on and conjugation of bilirubin: a fundamental concept in the mechanism ofneonatal jaundice. Pediatrics 2002; 110: e47 4.American Academy of Pediatrics Subcommittee on Hyperbilirubinemia. Ma-nagement of hyperbilirubinemia in the newborn infant 35 or more weeks ofgestation. Pediatrics. 2004;114(1):297. 5.Johnson L, Brown AK, Bhutani VK. BIND-a clinical score for bilirubin inducedneurologic dysfunction in newborns. Pediatrics Suppl 1999; 104: 746-747. 6.Shapiro SM. Definition of the clinical spectrum of kernicterus and bilirubininduced neurologic dysfunction (BIND). J Perinatol 2005; 25: 54-59. 7.Volpe JJ. Neurology of the Newborn, 4th Edition. Philadephia: WB Saunders, 2001 8.Stevenson DK, Fanarof AA, Maisels MJ, et al. Prediction of hyperbilirubine-mia in near-term and term infants. Pediatrics 2001; 108: 31-39. 9.American Academy of Pediatrics, Provisional Committee for Quality Impro-vement. Practice parameter: mamagement of hyperbilirubinemia in the he-alty term newborn. Pediatrics 1994; 94: 558-565. 10.Sarıcı SU, Serdar MA, Korkmaz A, et al. Incidence, course, and predictionof hyperbilirubinemia in near-term and term newborns. Pediatrics 2004; 113:775-780. 11.Tiker F, Gulcan H, Kilicdag H, Tarcan A, Gurakan B. Extreme hyperbiliru-binemia in newborn infants. Clin Pediatr (Phila). 2006; 45: 257-261. 12.Şenol V, Ünalan D, Çetinkaya F, Öztürk Y. Kayseri ilinde halk ebeliği ile il-gili geleneksel uygulamalar. Klinik Gelişim 2004; 17 (3/4): 47-55. 13.Türk Neonatoloji Derneği. Yenidoğan Sarılıklarına Yaklaşım, İzlem Ve Teda-vi Rehberi, 2014. 14.De Carvalho M, Holl M, Harvey D. Effects of water supplementation on physio-logical jaundice in breast-fed babies. Arch Dis Child 1981; 56: 568–569. 15.Nicoll A, Ginsburg R, Tripp JH. Supplementary feeding and jaundice in new-borns. Acta Paediatr Scand. 1982; 71: 759–761. 16.Maisels MJ, Bhutani VK, Bogen D Newman TB, Stark AR, Watchko JF. Hyper-bilirubinemia in the newborn infant ≥35 weeks gestation: an update with cla-rification. Pediatrics 2009; 124: 1193-1198. 17.Kaplan M, Merlob P, Regev R. Israel guidelines for the management of neonatal hyper-bilirubinemia and prevention of kernicterus. J Perinatol 2008; 28: 389-397 18.Hannam S, McDonnell M, Rennie JM. Investigation of prolonged neonataljaundice. Acta Paediatr 2000; 89: 694-697. 19.Lawrence M. Gartner, MD. Breastfeeding and jaundice.J Perinatol. 2011;21:21-25 20.Wong RJ, DeSandre GH, Sibley E, Stevenson DK. Neonatal jaundice and li-ver disease. In: Fanaroff AA, Martin RJ (eds). Neonatal-Perinatal Medici-ne Disease of the Fetus and Infant. 2006;8(1):1419-1466. 21.Gartner LM. Neonatal jaundice. Pediatr Rev. 1994;15:422. 22.Sarici SU, Saldir M. Genetic factors in neonatal hyperbilirubinemia and ker-nicterus. Turk J Pediatr. 2007;49:245-249 23.McKiernan PJ. Neonatal cholestasis. Semin Neonatol. 2002:7;153-157.
Details
| Primary Language | Turkish |
|---|---|
| Journal Section | makale |
| Authors | |
| Publication Date | July 3, 2019 |
| Published in Issue | Year 2019 Volume: 11 Issue: 4 |
