الفهرس 
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Abstract
Jaundice is the visible manifestation in skin and sclera of elevated serum concentration of bilirubin. Neonatal jaundice may not appear until serum bilirubin exceeds 5 to 7 mg/dl. Any serum total bilirubin (STB) elevation exceeding 17 mg/dl (291μmol/l) is considered pathologic and warrants investigations for a cause and possible therapeutic intervention.
Neonatal hyperbilirubinaemia is a cause of concern for the parents, and paediatricians as well. It occurs in 5-10% of healthy term infants. Neonatal hyperbilirubinaemia is the most common reason of readmission after early hospital discharge. Concerns regarding jaundice have increased after reports of bilirubin induced brain damage occurring in healthy term infants even without haemolysis.
Early discharge of healthy term newborns after delivery has become a common practice, because of medical and social reasons and economic constrains. Thus, the recognition, follow up and early treatment of jaundice has become more difficult as a result of early discharge from the hospital.
Severe jaundice and even kernicterus can occur in some full term healthy newborns discharged early with no apparent early findings of haemolysis.
The American Academy of Pediatrics recommends that newborns discharged within 48 hours should have a follow up visit after 2-3 days for any significant jaundice and other problems. This recommendation is not appropriate for our country due to limited follow up facilities in the community. Therefore, it is difficult to predict which infants are at increased risk for significant and relatively late hyperbilirubinaemia. And as such from the obvious need to design and implement a follow up programme, the present study was conducted to find out the critical value of serum bilirubin and haptoglobin in the cord blood in predicting the subsequent development of hyperbilirubinemia in healthy term and near term newborn.
This study was done on 61 of healthy term and near term newborns delivered at EL MENOUFIA UNIVERSITY HOSPITAL. During the study 15 babies were excluded at the start of this study because parents did not come for follow up. the study was continued on the remaining 46 newborns.
Mothers aged 22-45years with a mean age of 30.54 ± 3.91 were included in the study. Their gestational ages was in a range of 35-40 weeks in a mean of 37.69 ± 2.04. Of these mothers 19 mothers having normal vaginal delivery in a percentage of 41.3% and 27 mothers having a cesarean section delivery in a percentage of 58.7%. The number of male deliveries was 21 in a percentage of 45.7% in comparison to 25 females in a percentage of 54.3%. There is no case of case where vacuum extraction was applied during delivery. All cases were breastfed after delivery.
Infants whose mothers could not recall the exact date (first day) of last menstrual period and/or those who had a critical discrepancy (2 weeks)