Neonatal Jaundice
Neonatal jaundice is a condition which may be normal, or the consequence of underlying disease affecting either the liver or the breakdown of blood cells. So - called ‘normal’ or ‘physiologic’ jaundice is due to the immaturity of the neonatal liver to take up and conjugate the bilirubin quickly enough, or, in breast-fed babies, inhibition of the uptake of the bilirubin. The jaundice is not severe, and usually fades. Jaundice that persists or increases needs both investigation and treatment: that due to liver disease such as biliary atresia (described in this section) needs treatment of the disease, that due to thyroid failure needs treatment with thyroxine, that due to blood group incompatibility between mother and foetus, causing increased breakdown of blood cells, may need exchange transfusion.
Physiologic jaundice, and jaundice due to the breakdown of blood cells (haemolysis) is caused by the presence of unconjugated bilirubin (i.e. bilirubin not bound to glucuronic acid by liver cells). At high levels this is toxic to brain cells, and can cause a condition called kernicterus, which produces fits and possible mental retardation - which is why jaundice in the neonate needs monitoring.
|
