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Neonatal jaundice

最后审阅: 14 Feb 2025
最后更新: 21 Nov 2023

小结

定义

病史和体格检查

关键诊断因素

  • presence of risk factors
  • cephalocaudal progression
  • decreasing gestational age
  • male
  • family history of jaundice
  • family history of anemia
  • family history of splenectomy
  • maternal exposure to sulfonamides or antimalarials
  • hepatosplenomegaly
  • microcephaly
  • chorioretinitis
  • small for gestational age
  • cephalhematoma
  • hypertonia
  • high-pitched cry
  • retrocollis
  • opisthotonus
完整详情

其他诊断因素

  • perinatal asphyxia
  • macrosomia
  • plethora
  • hypotonia
  • lethargy
完整详情

危险因素

  • Asian
  • American-Indian
  • maternal diabetes
  • oxytocin in labor
  • low birth weight
  • decreased gestational age
  • decreased caloric intake and weight loss
  • breast-feeding
  • delayed cord clamping (2 to 3 minutes)
  • genetic factors
完整详情

诊断性检查

首要检查

  • transcutaneous bilirubin (TcB)
  • total serum bilirubin
  • direct Coombs test
  • direct serum bilirubin
完整详情

需考虑的检查

  • hematocrit
  • CBC
  • reticulocyte count
  • peripheral blood smear
  • blood groups
  • glucose-6-phosphate dehydrogenase (G6PD) screening
  • osmotic fragility test
  • blood culture
  • liver function tests
  • urine for reducing substances
  • plasma amino acids
  • urine organic acids
  • urine culture
  • abdominal ultrasound
  • percutaneous liver biopsy
完整详情

治疗流程

急症处理

physiologic hyperbilirubinemia

pathologic hyperbilirubinemia: unconjugated

pathologic hyperbilirubinemia: conjugated

breast-feeding/breast milk jaundice

撰稿人

作者

Vineet Bhandari, MBBS, MD, DM
Vineet Bhandari

Division Head, Neonatology

Vice Chair, Faculty Development

Department of Pediatrics

The Children's Regional Hospital at Cooper

Professor of Pediatrics, Obstetrics and Gynecology and Biomedical Sciences

Cooper Medical School of Rowan University

Camden

NJ

利益声明

VB declares that he has no competing interests.

同行评议者

Rima Fawaz, MD

Associate Professor of Pediatrics

Medical Director, Pediatric Hepatology and Pediatric Liver Transplantation

Yale University School of Medicine

New Haven

CT

利益声明

RF declares that she has no competing interests.

Alex Kemper, MD, MPH, MS

Professor of Pediatrics

Division Chief of Primary Care Pediatrics

Nationwide Children's Hospital

Columbus

OH

利益声明

AK declares that he has no competing interests.

Helen McElroy, MBChB, MRCPI, MSc

Consultant Neonatologist

Neonatology

Medway Maritime Hospital

Gillingham

UK

利益声明

HM declares that she has no competing interests.

  • 指南

    • Clinical practice guideline revision: Management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation
    • Technical report: Diagnosis and management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation
    更多 指南
  • 患者教育信息

    Jaundice in newborn babies: what is it?

    Jaundice in newborn babies: what treatments work?

    更多 患者教育信息
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