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Icterícia neonatal

Última revisão: 13 Aug 2025
Última atualização: 21 Nov 2023

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

  • presença de fatores de risco
  • progressão cefálico-caudal
  • menor idade gestacional
  • sexo masculino
  • história familiar de icterícia
  • história familiar de anemia
  • história familiar de esplenectomia
  • exposição materna a sulfonamidas ou antimaláricos
  • hepatoesplenomegalia
  • microcefalia
  • coriorretinite
  • pequeno para a idade gestacional
  • céfalo-hematoma
  • hipertonia
  • choro em tom agudo
  • retrocolo
  • opistótono
Detalhes completos

Outros fatores diagnósticos

  • asfixia perinatal
  • macrossomia
  • pletora
  • hipotonia
  • letargia
Detalhes completos

Fatores de risco

  • Asiáticos
  • Índio norte-americano
  • diabetes materno
  • oxitocina no trabalho de parto
  • baixo peso ao nascer
  • menor idade gestacional
  • menor ingestão de calorias e perda de peso
  • aleitamento materno
  • clampeamento tardio do cordão (2-3 minutos)
  • fatores genéticos
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • bilirrubina transcutânea
  • bilirrubina sérica total
  • teste de Coombs direto
  • bilirrubina sérica direta
Detalhes completos

Investigações a serem consideradas

  • hematócritos
  • Hemograma completo
  • contagem de reticulócitos
  • esfregaço de sangue periférico
  • grupos sanguíneos
  • rastreamento da glicose-6-fosfato desidrogenase (G6PD)
  • teste de fragilidade osmótica
  • hemocultura
  • testes da função hepática
  • substâncias redutoras na urina
  • aminoácidos plasmáticos
  • ácidos orgânicos urinários
  • urocultura
  • ultrassonografia abdominal
  • biópsia hepática percutânea
Detalhes completos

Algoritmo de tratamento

AGUDA

hiperbilirrubinemia fisiológica

hiperbilirrubinemia patológica: não conjugada

hiperbilirrubinemia patológica: conjugada

icterícia do aleitamento materno/leite materno

Colaboradores

Autores

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

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.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

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.Full text

Woodgate P, Jardine LA. Neonatal jaundice: phototherapy. BMJ Clin Evid. 2015 May 22;2015:. Abstract

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.Full text  Abstract

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. Abstract

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
  • Guidelines

    • Jaundice in newborn babies under 28 days
    • Technical report: Diagnosis and management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation
    More Guidelines
  • Patient information

    Icterícia em neonatos: quais tratamentos funcionam?

    Icterícia em neonatos: o que é?

    More Patient information
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