Резюме
Определение
Анамнез и осмотр
Ключевые диагностические факторы
- 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
Другие диагностические факторы
- asfixia perinatal
- macrossomia
- pletora
- hipotonia
- letargia
Факторы риска
- 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
Диагностические исследования
Исследования, которые показаны в первую очередь
- bilirrubina transcutânea
- bilirrubina sérica total
- teste de Coombs direto
- bilirrubina sérica direta
Исследования, проведение которых нужно рассмотреть
- 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
Алгоритм лечения
hiperbilirrubinemia fisiológica
hiperbilirrubinemia patológica: não conjugada
hiperbilirrubinemia patológica: conjugada
icterícia do aleitamento materno/leite materno
Составители
Авторы
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
Disclosures
VB declares that he has no competing interests.
Peer reviewers
Rima Fawaz, MD
Associate Professor of Pediatrics
Medical Director, Pediatric Hepatology and Pediatric Liver Transplantation
Yale University School of Medicine
New Haven
CT
Disclosures
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
Disclosures
AK declares that he has no competing interests.
Helen McElroy, MBChB, MRCPI, MSc
Consultant Neonatologist
Neonatology
Medway Maritime Hospital
Gillingham
UK
Disclosures
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
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;2015:0319.Full text 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
- Phototherapy to prevent severe neonatal hyperbilirubinemia in the newborn infant 35 or more weeks of gestation: technical report
- Jaundice in newborn babies under 28 days
More GuidelinesPatient information
Icterícia em neonatos: quais tratamentos funcionam?
Icterícia em neonatos: o que é?
More Patient information
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