Elevated Bilirubin In Newborns

2024 Author: Josephine Shorter | [email protected]. Last modified: 2023-12-16 21:43

Elevated bilirubin in newborns

It is no coincidence that, unlike many adults, increased bilirubin is considered a frequent occurrence in newborns. This is often due to the destruction of typical fetal hemoglobin, which in its structure is always slightly different from the hemoglobin formed after birth. Since fruiting hemoglobin is always actively destroyed, this provokes an increase in the level of bilirubin. Often, even the most physiological jaundice will go away over time without any treatment. But in some serious cases, phototherapy is indicated.

It must be said that bilirubin is a special bile pigment with an unusual yellow-brown color. It is always formed by the breakdown of proteins and hemoglobin in the blood. In addition, it is found in plasma. The levels of bilirubin in a newborn and an adult differ significantly. As a rule, in most children older than one or one and a half months and in many adults, the bilirubin content usually ranges from 8.5 to 20.5 μmol / L. But in many newborns, it can reach 205 μmol / l, and in some cases even more.

There is no need to be alarmed, since such high rates in newborns are always understandable. While in the womb, the baby does not breathe on its own. However, oxygen enters all of its tissues through erythrocytes, which contain fetal hemoglobin. It is this hemoglobin of the fetus that begins to break down immediately after birth, the baby no longer needs it. This is why the baby's skin begins to take on a darker tone.

This free indirect bilirubin is insoluble and cannot be excreted by the kidneys. It circulates in the blood of the newborn for a certain amount of time until the baby's enzyme systems are fully matured. As soon as these unique systems begin to work actively, free bilirubin is easily converted into direct bilirubin and is quickly excreted from the child's body.

Jaundice in newborns

An increase in this pigment is significantly higher than normal in newborns, which makes it possible to diagnose jaundice. Jaundice can be physiological or pathological. Normal physiological jaundice occurs in the vast majority of newly born babies. It appears on about 3 or 4 days, and then disappears without a trace.

This jaundice does not harm a small body. The specific level of increase in bilirubin depends primarily directly on the maturity of the fetus itself. Also, jaundice is influenced by the very course of pregnancy in the mother. Various problems and diseases of the mother can provoke an increase in pigment in the blood of the baby after birth. The main factor is the diabetes mellitus of the expectant mother. In other cases, the occurrence of such jaundice is due to intrauterine hypoxia or fetal asphyxia.

Pathological jaundice is characterized by a significant increase in bilirubin in the baby's blood. The causes of this condition are infectious liver damage, serious intestinal obstruction, genetically determined severe destruction of red blood cells, incompatibility of the mother and the newborn himself with the Rh factor or blood group, obstructive jaundice, hormonal disorders, as well as constitutional hepatic dysfunction, in other words, the dangerous Gilbert syndrome.

There are many reasons and only a highly qualified doctor can make the correct diagnosis. One of the initial diagnostic methods is considered to be a full-fledged study of a child's blood test for bilirubin and its various fractions. After determining such indicators, other tests and examinations are prescribed, after which the doctor makes a final diagnosis and prescribes the necessary treatment.

How dangerous is an increase in bilirubin in newborns?

The main danger of increased bilirubin in newborns is toxic effects. This pigment cannot be completely blocked by typical blood albumin, which causes it to enter the nervous system. This condition is extremely dangerous for all vital nerve centers and, of course, for the child's brain. This dangerous bilirubin encephalopathy usually manifests itself in the first day after the birth of the baby.

The disease is manifested by such a decrease in the sucking reflex, severe drowsiness of the newborn, a significant decrease in blood pressure, motor restlessness and convulsions, as well as a significant increase in the liver and spleen. In some cases, in the absence of the necessary treatment by 6 months, the baby's hearing is impaired, mental development slows down and paralysis is possible. That is why high bilirubin in a newborn is a reason for serious treatment and further observation by a neurologist.

In physiological jaundice, phototherapy, in other words, phototherapy, is always the simplest and at the same time effective method of reducing high levels of bilirubin. It is under the influence of light that typical indirect bilirubin instantly turns into non-toxic simple lumirubin, and then, within about 12 hours, is excreted from the body in the feces and always in the urine. The side effects of this treatment can include loose stools and noticeable flaking of the skin, but these quickly subside.

In any case, the treatment of such a disease always takes place in a hospital under the strict supervision of pediatricians for a dynamic improvement in the condition of the newborn.

The author of the article: Sokolova Praskovya Fedorovna | Pediatrician

Education: Diploma in the specialty "General Medicine" received at the Volgograd State Medical University. A specialist certificate was immediately received in 2014.