Whenever I study an interesting topic in Obstetrics and Gynaecology,I use this blog to share the information.
I checked the facts as much as I can.l will link to the relevant documents and give the references whenever possible.Please be kind enough to make comments.
I hope this blog is also useful for the MRCOG Exam(members of Royal college of Obstetricians & Gynaecologists).
My Twitter account is http://www.twitter.com/ravimohanv
Wednesday, 19 December 2007
MRCOG Neonatal Jaundice
Why it is important to recognise and treat neonatal jaundice?
Bilirubin is toxic to the brain. Uncojugatedbilirubin is lipid soluble but conjugated bilirubin is water soluble.
Bilirubin is prevented from entering the brain by blood brain barrier under normal circumstances.However the blood brain barrier isn’t well developed in the newborn.Uncojugated bilirubin(lipid soluble) could cross to the newborn and would cause encephalopathy.(Kernicterus)
Fetal bilirubin is excreted via placenta and is cleared by maternal liver. Once delivered baby’s liver should take over.
Causes of neonatal jaundice could be broadly categorisedas
(ii)intrahepatic(interference with conjugation)
(A) Prehepaticprehepatic:haemolyticanaemia-Rhesus incompatibility/ABO incompatibility
(B) Intrahepatic:prematurity-liver enzymes system is immature to handle the conjucation
(C) Post hepatic:Biliary atresia,Choledochal cyst