الفهرس 
neonatal hyperbilirubinemiaOnly 14 pages are availabe for public view
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Abstract
The high incidence of neonatal jaundice combined with the
shortening of post natal stay at hospital make the early screening and
surveillance for neonatal hyperbilirubinemia essential to ensure that these
infants are not missed, as it is still not known at what level bilirubin can
cause a significant risk of brain damage.
So before discharge, every newborn infant should be assessed for
the risk of hyperbilirubinemia. The predischarge bilirubin measurements
using TSB or TCB and/or assessment of clinical risk factors are used as
screening tools for predicting the neonatal hyperbilirubinemia.
This study aimed at detecting the incidence of neonatal
hyperbilirubinemia at Shebeen Elkoom teaching hospital among the
period from January, 2007 through June, 2007, predicting the neonatal
jaundice by using the both clinical scoring system and TCB
measurements and finally performing a correlation between TCB and
TSB.
Our study included 230 neonates, of them 72 cases (31.3%)
developed hyperbilirubinemia.
There was a statistically significant increase in the incidence of
neonatal hyperbilirubinemia in babies whose mothers had hypertension,
pre eclampsia, diabetes mellitus, obstructed labor and mothers with
previous jaundiced baby. While there was no statistically significant
increase in the incidence of neonatal hyperbilirubinemia in babies whose
mothers had vaginal bleeding, prolonged rupture of membranes, oxytocin
use and mothers delivered by CS.
Summary & Conclusion
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There was a statistically significant increase in the incidence of
neonatal hyperbilirubinemia in babies with cephalohematoma, premature
delivery, those with SGA, those with combined breast and bottle feeding
and male infants. There was no statistically significant increase in the
incidence of neonatal hyperbilirubinemia among the babies with
exclusive breastfeeding.
There was a very strong positive correlation between TSB and
TCB with (r=0.997).
A clinical risk scoring also was suggested for detection of neonatal
hyperbilirubinemia but we found that there is a priority for using
predischarge TCB rather than the clinical scoring system in prediction of
neonatal hyperbilirubinemia.
from the above results it is concluded that:-
1- Every newborn should be assessed for the risks of developing
sever hyperbilirubinemia postnattaly.
2- Early prediction of neonatal hyperbilirubinemia by predischarge
TCB or TSB and/or assessment of clinical risk factors are
important to avoid the hazards of sever hyperbilirubinemia and
its threat of brain damage.
3- The predischarge bilirubin measurement is more accurate and
generates wider risk stratification than a clinical risk factor.
4- TCB measurements had demonstrated a strong positive linear
correlation with TSB.
5- Exclusive breastfeeding decrease the incidence of neonatal
jaundice compared to bottle feeding, but if these infants are
starved or dehydrated, they could probably be at higher risk of
bilirubin encephalopathy.
6- There is no effect of oxytocin used for labor induction in the
incidence of neonatal jaundice.