Nilesh Ahire ¹, Ravindra Sonawane ¹, Rajendra Gaikwad ¹, Suhas Patil ¹, Tushar Sonawane

Affiliations
1 Department of Paediatrics, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik - 422203, Maharashtra, IN

Abstract

Introduction: Neonatal Hyperbilirubinemia (NH) is a universal problem affecting nearly 60% of term and 80% of preterm neonates during first week of life. Early discharge of healthy term newborns is a common practice because of medical, social and economic constraints. Insignificant number (6.5%) of babies, NH is a cause for readmission. The present study was conducted to correlate the Cord Blood Bilirubin (CBB) level with subsequent NH. Methods: Study was performed at the Department of Pediatrics in a Medical College Hospital and Research Centre. Intramurally delivered, 113 Healthy full-term newborns during 1-year period were prospectively enrolled. CBB was estimated. Serum Bilirubin estimation was done at 48 hours and 5 day of age and later if required. Results: Significant NH in our study is 3.5%. Mean total bilirubin on second postnatal day was 10.58 mg/dl and on fifth post natal day was 10.81 mg/dl. Using CBB level of ≥3 mg/dl as a cut-off, NH can be predicted with sensitivity of 100%, specificity of 98.17%, positive predictive value of 66.67% and negative predictive value of 100%. Conclusion: A 100% Negative Predictive Value in the present study suggests that in Healthy Term babies (without RH and ABO incompatibility with Cord Blood Bilirubin ≤3mg/dl) cord serum bilirubin can help to identify those newborns who are unlikely to require further evaluation and intervention. These newborns can be discharged with assurance to Parents. Babies with CBB level ≥3mg/dl should be followed more frequently.

Keywords

Cord Bilirubin, Hyperbilirubinemia, Newborns, Neonate.

Full Text

   

Ravindra S. Sonawane ¹, Ripal Dipak Shah ², Sagar Sonawane ³, Rajendra Gaikwad ⁴

Affiliations
1 Professor and Head, Department of Paediatrics, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik – 422003, Maharashtra, IN
2 Former PG Resident, Department of Paediatrics, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik – 422003, Maharashtra, IN
3 Associate Professor, Department of Paediatrics, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik – 422003, Maharashtra, IN
4 Professor, Department of Paediatrics, Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik – 422003, Maharashtra

Abstract

Background: Early diagnosis of congenital heart disease is important for a good clinical outcome. Unrecognized or delayed diagnosis of some severe congenital heart diseases can lead to cardiac failure, cardiovascular collapse, and even death. Pulse oximetry screening (POS) in newborns has been shown to enhance the detection of critical congenital heart disease (CCHD). Clinical evaluation is likely to miss the diagnosis in first few hours of hospital stay after birth due to absence of signs and symptoms of CCHD. In the absence of clinical findings during early neonatal period, the best parameter that can be assessed, is the detection of hypoxemia by pulse oximetry screening. Aims and Objectives: Usefulness of pulse oximetry in newborn for early detection of Critical Congenital Heart Disease (CCHD). Material and Methods: This Prospective Observational Study was conducted on 125 newborn babies in postnatal ward at tertiary care centre for a period of 2 years satisfying the inclusion and exclusion criteria. Evaluation was done between 24 to 48 hours of birth with pulse oximeter. Institutional ethics committee permission was taken prior to study. Results and Conclusion: Total 125 neonates were screened by pulse oximeter, 2 were detected to have positive screen for Congenital Heart Disease (CHD) of which 1 had CCHD confirmed by echocardiography. Study revealed that Pulse Oximetry screening can be an important screening tool in routine neonatal care for early detection of CCHD.

Keywords

Critical Congenital Heart Disease, Pulse Oximetry

Full Text