Resumo
Definição
História e exame físico
Principais fatores diagnósticos
- 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
Outros fatores diagnósticos
- perinatal asphyxia
- macrosomia
- plethora
- hypotonia
- lethargy
Fatores de risco
- 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
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- transcutaneous bilirubin (TcB)
- total serum bilirubin
- direct Coombs test
- direct serum bilirubin
Investigações a serem consideradas
- 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
Algoritmo de tratamento
physiologic hyperbilirubinemia
pathologic hyperbilirubinemia: unconjugated
pathologic hyperbilirubinemia: conjugated
breast-feeding/breast milk jaundice
Colaboradores
Autores
Vineet Bhandari, MBBS, MD, DM

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
Declarações
VB declares that he has no competing interests.
Revisores
Rima Fawaz, MD
Associate Professor of Pediatrics
Medical Director, Pediatric Hepatology and Pediatric Liver Transplantation
Yale University School of Medicine
New Haven
CT
Declarações
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
Declarações
AK declares that he has no competing interests.
Helen McElroy, MBChB, MRCPI, MSc
Consultant Neonatologist
Neonatology
Medway Maritime Hospital
Gillingham
UK
Declarações
HM declares that she has no competing interests.
Créditos aos pareceristas
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Declarações
As afiliações e declarações dos pareceristas referem--se ao momento da revisão.
Referências
Principais artigos
Kemper AR, Newman TB, Slaughter JL, et al. Clinical practice guideline revision: management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. Pediatrics. 2022 Sep 1;150(3):e2022058859.Texto completo
Woodgate P, Jardine LA. Neonatal jaundice: phototherapy. BMJ Clin Evid. 2015 May 22;2015:0319.Texto completo Resumo
Slaughter JL, Kemper AR, Newman TB. Technical report: Diagnosis and management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. Pediatrics. 2022 Sep 1;150(3):e2022058865.Texto completo Resumo
Gu J, Zhu Y, Zhao J. The efficacy of intravenous fluid supplementation for neonatal hyperbilirubinemia: a meta-analysis of randomized controlled studies. J Matern Fetal Neonatal Med. 2019 Nov 17;1-6. Resumo
Artigos de referência
Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
Diretrizes
- Phototherapy to prevent severe neonatal hyperbilirubinemia in the newborn infant 35 or more weeks of gestation: technical report
- Technical report: Diagnosis and management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation
Mais DiretrizesFolhetos informativos para os pacientes
Jaundice in newborn babies: what is it?
Jaundice in newborn babies: what are the treatment options?
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