1. RAPHA SPECIALIST CHILDREN & GENERAL CLINIC, 85 AIRPORT ROAD, EFFURUN.
NEONATAL JAUNDICE BY
DR BLESSING OFEJIRO OKPERI
B.Med.Sc.(Hons), MBBS, FWACP (Paed)
SENIOR LECTURER / CONSULTANT PAEDIATRICIAN
H.O.D, DEPT OF PAEDIATRICS,
DELSU & DELSUTH.
MEDICAL DIRECTOR
RAPHA SPECIALIST CHILDREN & GENERAL CLINIC, AIRPORT ROAD, EFFURUN.

2. PRE - TEST What the causes jaundice in neonates?
How is jaundice diagnosed?
What is physiologic jaundice?
Which of the following is useful for Rx :
Early morning sunlight
(b) Glucose + Ampiclox
(c ) Phenobarbitone

3. LEARNING OBJECTIVES DEFINE JAUNDICE PATHOPHYSIOLOGY OF JAUNDICE
DANGER OF JAUNDICE
DEBUNKING WRONG TREATMENTS
EMPHASIZING PROMPT & EFFECTIVE
TREATMENT

4. DEFINITION PREVALENCE BURDEN OF THE DISEASE
INTRODUCTION
DEFINITION
PREVALENCE
BURDEN OF THE DISEASE

5. BILIRUBIN METABOLISM SOURCES OF BILIRUBIN HEMOLYSIS
BILIRUBIN BINDING TO ALBUMIN
LIVER UPTAKE
BINDING TO LIGADIN Y & Z
CONJUGATION WITH UDPGT
EXCRETION INTO BILE
ENTEROHEPATIC CIRCULATION

6. PHYSIOLOGIC JAUNDICE DEFINITION CAUSES - RBC VOL ,RBC SURVIVAL,ELB,EHC
-DEFECTIVE UPTAKE
-DEFECTIVE CONJUGATION
-REDUCED EXCRETION
RATE OF RISE AND PEAK

7. PATHOLOGIC JAUNDICE DEFINITION CAUSES -POLYCYTHAEMIA -HEMOLYSIS
-BILIRUBIN DISPLACEMENT
-HEPATOBILIARY DISEASES
RATE OF RISE AND PEAK

8. BILIRUBIN TOXICITY
PATHOLOGY: UNCOUPLING OF OXIDATIVE PHOSPHORILATION, NEURONAL CELL DEATH
WORSE HIT:BASALGANGLIA,GLOBUS
PALLIDUS,PUTAMEN,CAUDATE NUCLEI
+ CH, BULBAR & CEREBELLAR NUCLEI

9. CLINICAL STAGING 1.POOR MORO,HYPOTONIA,LETHARGY
POOR FEEDING, HIGH PITCH CRY
2.OPISTHOTONUS,HYPERTONIA,FEVER
SEIZURES,ROWING “BICYCLING”
PARALYSIS OF UPWARD GAZE
3.APPARENT RECOVERY
4.LATE SEQUELAE: SPASTICITY,ATHETOSIS
COMPLETE OR PARTIAL DEAFNESS, CP, MR

10. CLINICAL EVALUATION VISUAL ESTIMATION(ROUGH GUIDE)
SB (TOTAL & CONJUGATED)
PCV & COOMBS
CONJ BIL < 2mg% VERSUS > 2mg %
PCV HIGH VS NORMAL OR LOW
RETIC NORMAL VS ABNORMAL

11. TREATMENT PHOTOTHERAPY:INDICATIONS,MOA LIGHT SOURCE, TECHNIQUE, PHOTO
BLANKET
EBT; INDICATIONS,MOA, TECHNIQUE
PHENOBARBITONE: MOA, DEMERITS
CONTEMPORARY INDICATIONS
ACTIVATED CHARCOL
TIN PROTOPORPHYRIN

12. CONCLUSION NO ROASTING OF BABY IN THE SUN NO AMPICLOX AND GLUCOSE
NO DELAY TO REFER BABY
STOP CEREBRAL PALSY PLEASE!!!!!