Summary
Definition
History and exam
Key diagnostic factors
- presence of risk factors
- cephalocaudal progression
- decreasing gestational age
- male
- family history of jaundice
- family history of anaemia
- family history of splenectomy
- maternal exposure to sulphonamides or antimalarials
- hepatosplenomegaly
- microcephaly
- chorioretinitis
- small for gestational age
- cephalhaematoma
- hypertonia
- high-pitched cry
- retrocollis
- opisthotonus
Risk factors
- East Asian
- American-Indian
- maternal diabetes
- oxytocin in labour
- low birth weight
- decreased gestational age
- decreased caloric intake and weight loss
- breastfeeding
- delayed cord clamping (2-3 minutes)
Diagnostic investigations
1st investigations to order
- transcutaneous bilirubinometer
- total serum bilirubin
- direct Coombs' test
- direct serum bilirubin
- haematocrit
- FBC
- reticulocyte count
- peripheral blood smear
- blood groups
Investigations to consider
- glucose-6-phosphate dehydrogenase 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
Treatment algorithm
Contributors
Authors VIEW ALL
Professor of Pediatrics Obstetrics and Gynecology
Drexel University College of Medicine
Chief, Section of Neonatal Medicine
St. Christopher's Hospital for Children/Hahnemann University Hospital/Temple University Hospital
Philadelphia
PA
Disclosures
VB declares that he has no competing interests.
Peer reviewers VIEW ALL
Professor of Pediatrics
Baylor College of Medicine
Section Head and Service Chief of Neonatology
Texas Children's Hospital
Houston
TX
Disclosures
GKS declares that he has no competing interests.
Consultant Neonatologist
Neonatology
Medway Maritime Hospital
Gillingham
UK
Disclosures
HM declares that she has no competing interests.
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