HyperbilirubinemiaHyperbilirubinemiaHyperbilirubinemia

HyperbilirubinemiaHyperbilirubinemiaHyperbilirubinemiaHyperbilirubinemia

1. HYPERBILIRUBINEMIA

2. WHAT IS
HYPERBILIRUBINEMIA

3. HYPERBILIRUBINEMIA IN NEWBORNS, ALSO KNOWN AS
NEONATAL JAUNDICE, IS A COMMON CONDITION
CHARACTERIZED BY THE YELLOWING OF THE SKIN AND THE
WHITES OF THE EYES DUE TO ELEVATED LEVELS OF BILIRUBIN
IN THE BLOOD. BILIRUBIN IS A YELLOW PIGMENT PRODUCED
DURING THE NORMAL BREAKDOWN OF RED BLOOD CELLS.
IN NEWBORNS, JAUNDICE OFTEN OCCURS WITHIN THE FIRST
FEW DAYS AFTER BIRTH AS THEIR BODIES UNDERGO THE
PROCESS OF ADAPTING TO LIFE OUTSIDE THE WOMB. THIS
TYPE OF JAUNDICE, CALLED PHYSIOLOGIC JAUNDICE, IS
USUALLY HARMLESS AND RESOLVES ON ITS OWN WITHOUT
TREATMENT.

4. INCREASED BREAKDOWN OF RED BLOOD CELLS:
NEWBORNS HAVE A HIGHER RATE OF RED BLOOD CELL
BREAKDOWN, WHICH CAN LEAD TO ELEVATED BILIRUBIN
LEVELS.
1.
IMMATURE LIVER FUNCTION: A NEWBORN'S LIVER MAY
NOT BE FULLY DEVELOPED OR FUNCTIONING EFFICIENTLY
ENOUGH TO PROCESS BILIRUBIN EFFECTIVELY.
2.
BREASTFEEDING-RELATED JAUNDICE: IN SOME CASES,
INADEQUATE BREASTFEEDING CAN CONTRIBUTE TO
JAUNDICE, AS DEHYDRATION CAN LEAD TO INCREASED
BILIRUBIN LEVELS.
3.
BLOOD TYPE INCOMPATIBILITY: IF THE BABY AND MOTHER
HAVE DIFFERENT BLOOD TYPES, THE BABY MAY DEVELOP
JAUNDICE DUE TO THE BREAKDOWN OF INCOMPATIBLE
BLOOD CELLS.
4.
OTHER MEDICAL CONDITIONS: CERTAIN MEDICAL
CONDITIONS, SUCH AS INFECTIONS, METABOLIC
DISORDERS, OR LIVER DISEASE, CAN ALSO LEAD TO
HYPERBILIRUBINEMIA IN NEWBORNS.
5.
HOWEVER, IN SOME CASES, JAUNDICE
MAY BECOME MORE SEVERE, LEADING
TO HYPERBILIRUBINEMIA. THIS CAN
HAPPEN DUE TO VARIOUS REASONS:

5. WHAT CAUSES
HYPERBILIRUBINEMIA
HYPERBILIRUBINEMIA IN NEWBORNS,
COMMONLY KNOWN AS JAUNDICE, OCCURS
DUE TO THE ACCUMULATION OF BILIRUBIN
IN THE BLOOD. BILIRUBIN IS A YELLOW
PIGMENT PRODUCED DURING THE
BREAKDOWN OF RED BLOOD CELLS.

6. PATHOPHYSIOLOGY OF
HYPERBILIRUBINEMIA

7. HOW IS
HYPERBILIRUBINEMIA
DIAGNOSED?
CLINICAL ASSESSMENT:
HEALTHCARE PROVIDERS WILL OFTEN EXAMINE THE
NEWBORN FOR SIGNS OF JAUNDICE, WHICH IS THE
YELLOWING OF THE SKIN AND EYES DUE TO ELEVATED
BILIRUBIN LEVELS. THE EXTENT OF JAUNDICE MAY VARY
DEPENDING ON THE SEVERITY OF HYPERBILIRUBINEMIA.
THEY WILL ASSESS OTHER FACTORS SUCH AS THE BABY'S
GESTATIONAL AGE, BIRTH WEIGHT, AND OVERALL HEALTH.
BILIRUBIN MEASUREMENT:
SERUM BILIRUBIN LEVELS ARE MEASURED USING A BLOOD
TEST. THIS CAN BE DONE THROUGH A HEEL STICK OR
VENIPUNCTURE.
TOTAL SERUM BILIRUBIN (TSB) LEVELS ARE TYPICALLY
MEASURED, AND SOMETIMES, THE LEVELS OF
UNCONJUGATED (INDIRECT) AND CONJUGATED (DIRECT)
BILIRUBIN ARE ALSO MEASURED SEPARATELY.
TRANSCUTANEOUS BILIRUBINOMETRY (TCB):
THIS IS A NON-INVASIVE METHOD WHERE A DEVICE IS USED
TO MEASURE THE BILIRUBIN LEVELS THROUGH THE SKIN.

8. SYMPTOMS OF
HYPERBILIRUBINEMIA
YELLOWING OF THE EYES
YELLOWING OF THE SKIN
YELLOWING OF THE
MUCOUS MEMBRANES
POOR FEEDING
HIGH PITCHED CRYING
IRRITABILITY
DECREASED URINE OUTPUT
UNUSUAL STOOL COLOR

9. RISK FACTORS OF
HYPERBILIRUBINEMIA
PREMATURITY
EXCLUSIVE BREASTFEEDING
BREAST MILK JAUNDICE
BLOOD TYPE
INCOMPATIBILITY
PREVIOUS SIBLING WITH
JAUNDICE
EAST ASIAN DESCENT
GDM OR HYPERTENSION
MALE GENDER

10. HYPERBILIRUBINEMIA
CAN LEAD TO OTHER
COMPLICATIONS SUCH AS:
KINECTERUS
HEARING LOSS
ACUTE BILIRUBIN
ENCELOPATHY
DEVELOPMENTAL DELAYS
CEREBRAL PALSY
DEATH

11. KINECTERUS-THIS IS A RARE BUT SERIOUS COMPLICATION OF SEVERE HYPERBILIRUBINEMIA.
KERNICTERUS OCCURS WHEN BILIRUBIN LEVELS IN THE BLOOD ARE EXTREMELY HIGH AND
THE BILIRUBIN CROSSES THE BLOOD-BRAIN BARRIER, LEADING TO BRAIN DAMAGE. THIS
CAN CAUSE LONG-TERM NEUROLOGICAL PROBLEMS SUCH AS CEREBRAL PALSY, HEARING
LOSS, INTELLECTUAL DISABILITIES, AND MOVEMENT DISORDERS.
HEARING LOSS-SEVERE HYPERBILIRUBINEMIA CAN LEAD TO AUDITORY NEUROPATHY OR
SENSORINEURAL HEARING LOSS DUE TO DAMAGE TO THE AUDITORY NERVE OR THE
STRUCTURES OF THE INNER EAR.
ACUTE BILIRUBIN ENCELOPATHY-THIS IS THE ACUTE PHASE OF BILIRUBIN-INDUCED BRAIN
INJURY BEFORE IRREVERSIBLE DAMAGE OCCURS. SYMPTOMS CAN INCLUDE LETHARGY,
POOR FEEDING, HIGH-PITCHED CRYING, ARCHING OF THE BACK, AND ABNORMAL MUSCLE
TONE.
DEVELOPMENTAL DELAYS-PROLONGED OR SEVERE JAUNDICE IN NEWBORNS CAN
SOMETIMES RESULT IN DEVELOPMENTAL DELAYS OR COGNITIVE IMPAIRMENTS DUE TO
BRAIN DAMAGE CAUSED BY HIGH LEVELS OF BILIRUBIN.
CEREBRAL PALSY- IN SEVERE CASES OF HYPERBILIRUBINEMIA LEADING TO KERNICTERUS,
CEREBRAL PALSY CAN OCCUR DUE TO THE BRAIN DAMAGE CAUSED BY ELEVATED
BILIRUBIN LEVELS.
DEATH-ALTHOUGH RARE, UNTREATED SEVERE HYPERBILIRUBINEMIA CAN LEAD TO DEATH,
PARTICULARLY IN CASES WHERE KERNICTERUS DEVELOPS.

12. TREATMENTS FOR
HYPERBILIRUBINEMIA
PHOTOTHERAPY
EXCHANGE TRANSFUSION
FLUID AND NUTRITION
ADEQUATE BREASTFEEDING
MONITORING
TREATMENT OF
UNDERLYING CAUSES
EDUCATION AND SUPPORT
FOR PARENTS

13. THANK YOU!! (EME)