Neonatal jaundice - whether to panic?
A few days after the birth of the skin and sclera of a newborn baby becoming more or less pronounced yellowish tint.Often it scares inexperienced parents, but in most cases, this jaundice is not dangerous and is very fast.Nevertheless, jaundice requires medical supervision since it causes may be different.
Causes of jaundice
Bilirubin - a bile pigment that is formed after the breakup of the hemoglobin of red blood cells (red blood cells).Initially formed indirect or unconjugated bilirubin (UXO), which is captured by the liver cells from the blood and is subject to conjugation - under the influence of the enzyme glucuronyl NB is connected with glucuronic acid to form a linked or direct bilirubin (PB).Direct and a small amount of indirect bilirubin in the bile enter the intestine, where it is converted into new compounds that are excreted in the feces (stercobilin) and urine (urobilin).
fetus and newborn child sharing bilirubin has features that contribute to the accumulation in the blood and tissue penetration.During this period the life of the child in his blood contains red blood cells with the so-called fetal hemoglobin Hemoglobin: worse - low or high? , who grow old and decay faster than normal red blood cells, and therefore the amount of bilirubin in the blood increased.In fetal bilirubin undergoes virtually no conjugation due to lack of its enzymatic system, so fetal blood contained mainly UXO, which eliminated from the body with meconium (feces).
after birth the baby's blood increases the content of the National Bank and the phenomenon of jaundice appear.A few days later starts the enzyme system of the liver and in the body of the newborn begins a slow conversion of NB to PB and removing it from the body in feces, contributing to a gradual decrease in symptoms of jaundice.Fully neonatal liver enzyme system starts at 3-4 weeks of age.
Jaundice in newborns may be due to physiological characteristics of this age (while it proceeds differently in term and preterm infants), congenital and genetic disorders of theliver or bile ducts, the effects of different medications or intrauterine infection, blood incompatibility of mother and fetus, and so on.
Physiological neonatal jaundice
Physiological neonatal jaundice due to increased blood levels of the National Bank due to the imperfections of the enzymatic system of the liver.Elevated levels of UXO in the blood occurs in all newborns in the first days of life, but the yellowness of the skin marked little more than half of newborns.Since the amount of bilirubin in blood is accumulated gradually, physiological jaundice often on the third day of life.Yellowness appears first on the face, then on the trunk, extremities, conjunctiva of the eyes and mucous membranes.
4-6 day of life amounts of bilirubin in the blood reaches a maximum, after which its content is starting to decline (starts the enzyme system of the liver).Yellowness loses intensity and gradually disappears at the end of the first - the beginning of the second week of life.
general condition of the child at the physiological jaundice does not suffer, treatment of this condition is not usually required.Only in severe jaundice being treated as an intravenous injection of different solutions with the purpose of elimination of bilirubin from the body.
Jaundice of prematurity
Jaundice in preterm infants is more common than full-term.Premature neonates NB accumulation is slower, continuing a long and reaches higher concentrations, which creates a risk of bilirubin toxicity to the brain tissue damage (kernicterus).
level of bilirubin in the blood reaches a maximum at 5-6 days, jaundice lasts a total of 4-5 weeks.Severity of jaundice of prematurity is independent of birth weight, but is in direct proportion to the degree of maturity of the fruit and the presence of various diseases in the mother during pregnancy.
pronounced jaundice premature requires active treatment in the neonatal pathology unit at Children's Hospital.
hemolytic jaundice newborns
hemolytic neonatal jaundice may be due to incompatibility of blood between mother and fetus, or with a variety of hereditary diseases.
Hemolytic disease of the newborn is the result of immunological incompatibility conflict with the blood of the fetus and the mother.Most often, such a conflict arises in the blood incompatibility of Rh factor Rh factor - is still a medical mystery , present in red blood cells.When re pregnant Rh-negative mothers (not available in the erythrocytes of Rh-factor) Rh-positive fetus Rh blood of the fetus to the mother's body becomes alien (antigen).In response to the antigen in the mother's body develop antibodies Antibodies - "soldiers' immunity , who want to stick together with the antigen and to bring them out of the body.As a result, the child's body decays (hemolysis) of erythrocytes and accumulation of large amounts of indirect bilirubin.
Jaundice in this case appears at birth or in the first days of life.It changes the overall condition of the child: it is lethargic, bad and sucks a little move.As the level of free bilirubin Bilirubin - a great tool for the diagnosis in the blood of the newborn shows signs of disorders of the brain.This is a very dangerous condition because it can lead to irreversible changes in the central nervous system.Treatment should only be carried out in the hospital.
Jaundice in newborns may have different causes and consequences, to understand this may be a doctor.