Effectiveness of early clinical assessment and bilirubin estimation for prediction of neonatal hyperbilirubinemia

2016-03-14T07-32-15Z
Source: International Journal of Contemporary Pediatrics
Sharanabasappa S. Dhanwadkar, Christo S. Rasalam, Zakaulla Masood.
Background: Neonatal hyperbilirubinemia is common cause of neonatal morbidity seen in 60% term and 80% preterm neonate. Early clinical assessment and bilirubin estimation is important in preventing long term sequale of hyperbilirubinemia, preventable cause of neurological sequale (kernicterus). Methods: Clinical assessments of all preterm and term neonate born in our medical college were studied for effectiveness of early clinical assessment (Kramers index) compared to it gold standard test serum bilirubin (TB). Results: A total of 500 neonates were studied in which 11.4 % developed significant hyperbilirubinemia. Cord blood bilirubin has a PPV-63.9% and specificity-99.1%. Kramers index is less effective clinically if serum bilirubin is in lower range, comparatively Kramers index effectiveness increases as serum bilirubin increases with p value 0.001. Conclusions: 11.4% of neonates had significant hyperbilirubinemia requiring treatment. Umbilical cord bilirubin >3 mg/dl showed a good predictor for early detection of hyperbilirubinemia. Kramers index at 48 hours correlates significantly with higher levels of serum bilirubin with p value of 0.001.


from Scope via xlomafota13 on Inoreader http://ift.tt/1Rh9WT9
via IFTTT