实习英语查房－A case of neonatal jaundice1.ppt

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1、Neonatal Jaundice,Case: History(1),Baby Liu, 49 hrs old, was noted to be Jaundiced for about 30hrs (from 19hrs of life). Mother was a 26 years old G1 P0, she went into spontaneous labour at 40+6 wks, no premature rupture of membrane. APGARS were 9/9 at 1/5 minutes respectfully. Birth weight was 3260。

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2、g. Babys clinical examination post delivery was normal and baby roomed in with mother and breast feeding was attempted. Baby passed stool on two occasions, and the color was yellow.,History(2),There was no family history of jaundice, anemia, splenectomy, early gallbladder disease or liver disease.Mo。

3、ther was healthy during pregnancy.,The physical examination,On arrival to the hospital baby was nondysmorphic and his clinical exam was normal except he looked pale.Respiratory: No concerns baby remained well in room air. Cardiovascular: No concernsAbdomen: No abnormality detected. Baby fed well.CNS。

4、: Baby Liu was neurologically appropriate for age. He had good suck, moro and grasp reflex. There was no concern with his tone. There was no cephalohematoma.Haematology: His CBC on admission was Hb 108, WBC 12.5, platelets of 326, Ret 9%, CRP 2mg/L,Purpose of discussion,Further clinical testDiagnosi。

5、sTherapy,Question,Was this baby “physiologic jaundice” or “ nonphysiologic jaundice ”?,Physiologic Jaundice,The serum UCB level of most newborn infants rises to 2 mg/dL in the first week of life. This level usually rises in full-term infants to a peak of 6 to 8 mg/dL by 3 days of age and then falls.。

6、 A rise to 12 mg/dL is in the physiologic range. In premature infants, the peak may be 10 to 12 mg/dL on the fifth day of life, possibly rising 15 mg/dL without any specific abnormality of bilirubin metabolism.,Nonphysiologic Jaundice,Onset of jaundice before 24 hours of age.Any elevation of serum bilirubin that requires phototherapy (see next page). A rise in serum bilirubin levels of 0.5 mg/dL/hour or 5mg/dL/day . Direct bilirubin concentration 1.5- 2mg/d L Jaundice has withdrawed but reproduc。