Neonatal jaundice or hyperbilirubinemia is a common condition that occurs in a newborn infant. According to statistics by the Queensland clinical guidelines, relatively 60% of term and 80% of preterm babies are at risk developing neonatal jaundice during the first week of origin(Queensland Clinical Guidelines, 2017). Jaundice is caused by elevated levels of bilirubin in the blood and takes about 2 to 4 days after birth to be physically visible. The neonate presents with a yellowish appearance resulting from the deposition of bilirubin in the skin as a result of increased red cell breakdown and decreased bilirubin excretion. This essay will focus on Jennifer a neonate born preterm due to premature rupture of membranes (PPROM) at 33 weeks gestation …show more content…
The bilirubin in the liver is transported across the hepatic cell membranes, where it binds to ligandin a hepatic protein for the process of conjugation. An enzyme in the liver conjugates bilirubin, which converts it to water-soluble bilirubin pigments that can be excreted into the bile and exit the body. Bilirubin pigments which are not excreted from the gut can be assimilated back into the circulation as unconjugated bilirubin. This process primarily recycles the bilirubin, which is also known as enterohepatic recirculation. Thus, neonates with reduced conjugation or excretion of bilirubin are at immense risk of acquiring …show more content…
If the concentration of unconjugated bilirubin in the blood is too high, and it breaches the blood-brain barrier and bilirubin encephalopathy occurs the consequences are severe (Lauer & Spector, 2018). Jennifer being a Premature neonate at 33 weeks gestation with very high levels of total serum bilirubin(TSB) count at 2 days post birth, requires close monitoring and medical treatments in order to prevent the severe effects of prolonged hyperbilirubinemia. Jennifer who is 48 hours post birth has TSB level at 220 micromols/L and should be considered for phototherapy and repeated bilirubin measurement in six hours. Normally in neonates, the TSB measurement should be (-- removed HTML --) 250 micromols/L immediate treatment of phototherapy is required (National Collaborating Centre for Women’s and Children’s Health, 2011). Phototherapy is an effective treatment method for neonatal jaundice where the exposure of the epidermis to a source of light could convert the unconjugated bilirubin molecules into water-soluble isomers that can be eliminated without further metabolism by the liver (Fisher & Lakshman, 2015). Phototherapy is similar to a transcutaneous medicine and when phototherapy occurs, an infusion of discrete photons of energy intake by the bilirubin(Stokowski, 2011). Effective phototherapy penetrates
Irradiation in the red/near-infrared spectrum (R/NIR, 630 – 1000 nm) has been recently used as a potential therapeutic strategy to treat different diseases and injuries such as Mitochondrial Disease, Degenerative Eye Diseases, Neurodegenerative Diseases, Cardiovascular Disease and Stroke, Metabolic Diseases (Eells et al., 2003), wound healing, central nervous system injury, and for restless leg syndrome (Fitzgerald et al., 2013).
a) Urinalysis with significantly increased amounts of blood (via dipstick and sediment), protein, and leukocytes as well as slightly increased bilirubin and slightly decreased pH;
In most hospital delivery rooms, the doctors will routinely clamp and sever the umbilical cord with in fifteen to thirty seconds of the mother giving birth. When clamping the cord, the doctors will clamp the cord in two places, one close to the infant and then again in the middle of the cord another clamp. By delaying the clamping, fetal blood in the placental transfusion can provide the infant with an additional thirty percent more blood volume and up to sixty percent more blood cells (McDonald, S., & Middleton, P., 2009). This reduces the risk of the hemorrhaging that could occur after birth. But with new ongoing studies, it is said that by delaying the clamping of the cor...
Uebel, P. (1999). A case study of antenatal distress and consequent neonatal respiratory distress. Neonatal Network. 18 (5). 67-70
• Jaundice. This is yellowing of the skin and eyes. In a newborn, jaundice is usually caused by a buildup of waste products in the blood due to the breakdown of red blood cells that the baby cannot get rid of fast
Chaparro CM, Neufeld LM, Tena Alavez G, Eguia-Liz Cedillo R, Dewey KG. Effect of timing of umbilical cord clamping on iron status in Mexican infants: a randomized controlled trial. Lancet 2012;367:1997–2004. Retrieved November 9, 2014
Cook Children NICU receives around one thousand babies per year. Since the new unit was opened two years ago, they have single rooms where the parents can stay with their babies overnight, and it is controlled individually according to the patients’ needs. In the single rooms they are able to accommodate twins, triplets and quadruplets. According to Carolyn Cowling (personal communication, April.18, 2014), who is the LCSW, preemies have shown an incredible improvement in their health and are able to go home faster because they have a quicker recovery. Single rooms also allow parents to be with their infants all the time they want, even spending the night with them. Since most of them are there for a long run, it provides the feeling of being in their home.
According to Lucile Packard Children’s Hospital, “In the United States, nearly thirteen percent of babies are born preterm, and many of these babies also have a low birth weight.” The baby may be put into the NICU for varies reasons. However, the most common reason that a child is put into the NICU is because he or she is premature. Premature means the baby was born before the 36 weeks. It is never good for a baby to be born early, as this could mean that the baby is not fully developed. There are other factors as to why a child may need to be put into the NICU after birth. For instance, birth defects can be the cause of why a baby is put into the NICU. A baby may be born with an infection such as herpes or chlamydia which can damage the newborns immune system at such a young age. Low blood sugar or hypoglycemia can also cause an infant to be put into the NICU. Some maternal factors of why a baby may be put into the NICU is if the mother is “younger than 16 or older than 40.” If the parent may be an alcoholic or expose the baby to drugs, this can put the child into NICU care. If the parent has an STD or sexual transmitted disease, the baby is most likely going to have to be put into the intensive care unit. “Twins, triplets, and other multiples are often admitted into the NICU, as they tend to be born earlier and s...
Maternal & Child Health Journal, 8(3), 107-110. Retrieved from http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=14089739&site=ehost-live.
Umberto de Vonderweid, Marialisa Leonessa, Family centered neonatal care, Early Human Development, Volume 85, Issue 10, Supplement 1, Proceedings and selected abstracts from 1st International Conference on Clinical Neonatology Torino, Italy, November 2009, October 2009, Pages S37-S38, ISSN 0378-3782, DOI: 10.1016/j.earlhumdev.2009.08.009.
Wolf, David. "Cirrhosis." Medscape reference. WebMd LLC, Sep 22 2011. Web. 4 Nov 2011. .
...at high altitude, the BPG level increases, allowing Hemoglobin to release O2 more easily. However BPG is absent in most fetal hemoglobin as they lack of beta chain and instead of gamma chain to have a higher oxygen binding affinity so it optimise the transfer of oxygen from the maternal to the detal circulation.
This disease is characterized by autoantibodies against intrinsic factor producing cells in the stomach (atrophic gastritis). Intrinsic factor is an important molecule that binds to vitamin B12 in the stomach, allowing the vitamin B12/intrinsic factor complex to become absorbed in the small intestine. Other disorders associated with B12 deficiency include celiac disease and inflammatory bowel disease – this occurs as a result of malabsorption. Individuals that have undergone bowel resection of the stomach or small intestine (e.g., ileum) are also at increased risk.
A neonatologist has many tasks and responsibilities before, during, and after the birth of an at-risk newborn. If there is reason to believe there are going to be complications with a birth that would cause negative side effects for the infant, a neonatologist will be brought in to help. In these high-risk situations, a team effort is required and the neonatologist takes the lead position. The neonatologist will be responsible for advising the parents on what to expect during and after labor. After the infant is born, the neonatologist has to find a method to properly care for the baby. Because most premature babies have a low birth-weight, their lungs need to be supported and they need to be kept warm. During this whole process, the neonatologist interacts with the parents to keep them updated on their baby’s condition (Weaver, 2009).
New technologies are being developed every day. The latest advance in fetal monitoring is the fetal oxygen monitor: “A device that directly measures fetal oxygen saturation during labor and delivery is now available and has the potential to reduce the number of Cesarean sections performed for non-reassuring heart rates.” (Mechcatie) The article by Mechcatie describes the monitor extremely well: “The device’s sensor, located at the end of a flexible tube, is made of pliable plastic and is inserted through the cervical os until it lies along the fetal cheek, where the pressure of the uterine wall keeps it in place during labor. The sensor shines light into the fetal skin and computes the oxygen saturation by measuring the color of the reflected light coming through the blood cells.”