Diagnosis
The first indication of elevated bilirubin levels and thus also of the kernic terus is the striking yellow skin color of the newborn. This is followed by a transcutaneous bilirubin determination, whereby the yellow color of the skin is measured with light signals. If elevated values are found, the bilirubin is precisely determined by taking a blood sample. Other blood values are also determined, such as liver enzymes or infection parameters, to rule out other causes. The kernicterus itself only becomes noticeable through the baby’s symptoms, which are caused by damage to brain structures.
Therapy
There are several treatment options, depending on the bilirubin level in the baby’s blood. If the indirect bilirubin value is above 15 mg/dl, phototherapy is used. This involves irradiating the baby’s skin with blue light with a specific wavelength.
This converts the water-insoluble indirect bilirubin into a water-soluble form that can be excreted through the bile or urine. If bilirubin levels exceed 25 mg/dl, or if phototherapy does not have the desired effect, a blood exchange transfusion is used. In this procedure, all the blood of the newborn is exchanged with donor blood.
Strict attention must be paid to compatible blood groups between donor and recipient. However, the exchange of all blood does not take place at once, but in 5-20 ml portions via a catheter in the baby’s umbilical vein. Side effects of this method can include infections, a drop in blood pressure, thromboses or immune reactions to the donated blood.
Prognosis
The prognosis of neonatal icterus without kernicterus is good and usually no secondary damage occurs. However, if the high bilirubin levels lead to a nuclear icterus, severe and irreversible late complications can occur. If no therapy is administered, numbness, cerebral seizures and psychomotor retardation (e.g., in the case of a stroke) may occur.B.
Movement disorders). Another late consequence is cerebral palsy, which is accompanied by severe forms of nictitus and can also lead to death.
- Spasticity,
- Bone and joint alterations,
- Intelligence impairment,
- Seizures, etc.
- Neonatal jaundice
- Blood group incompatibility
- Rhesus factor intolerance
- Jaundice
- Jaundice therapy
- Infantile Cerebral Palsy
- Phototherapy
