Pathologic jaundice is a medical condition. It occurs in newborns. It involves a rapid increase in bilirubin levels. This leads to yellowing of the skin and eyes. Unlike physiologic jaundice, pathologic jaundice requires immediate medical attention.
Understanding Pathologic Jaundice in Newborns
Causes of Pathologic Jaundice
Pathologic jaundice has several causes. These causes can be related to the baby’s liver function. They can also be related to red blood cell breakdown.
Blood Group Incompatibility
One common cause is blood group incompatibility. This occurs when the mother and baby have different blood types. For example, Rh incompatibility can lead to severe jaundice. This happens when an Rh-negative mother has an Rh-positive baby. The mother’s body creates antibodies against the baby’s red blood cells. This results in their destruction.
Genetic Disorders
Genetic disorders can also cause pathologic jaundice. Conditions like G6PD deficiency affect red blood cells. This deficiency leads to increased breakdown. This releases more bilirubin into the bloodstream.
Infections
Infections in newborns can cause pathologic jaundice. Sepsis is a severe infection that can affect the liver. This impairs its ability to process bilirubin.
Liver Disorders
Liver disorders in newborns are another cause. Conditions like biliary atresia affect bile ducts. This prevents the normal excretion of bilirubin.
Symptoms of Pathologic Jaundice
Yellowing of Skin and Eyes
The primary symptom is yellowing of the skin and eyes. This yellowing is more pronounced than in physiologic jaundice.
Dark Urine and Pale Stools
Dark urine and pale stools are common. This indicates the liver is not processing bilirubin properly.
Poor Feeding and Lethargy
Newborns with pathologic jaundice may have poor feeding. They may also be lethargic. This means they are less active than normal.
High-Pitched Cry
A high-pitched cry can be a sign. This indicates that the baby is in distress.
Diagnosis of Pathologic Jaundice
Physical Examination
A physical examination is the first step. The doctor will check the baby’s skin and eyes.
Blood Tests
Blood tests measure bilirubin levels. They also check for blood group incompatibility.
Liver Function Tests
Liver function tests assess how well the liver is working. They check for any underlying liver disorders.
Genetic Testing
Genetic testing may be done. This helps identify any genetic causes of jaundice.
SEE ALSO: What Is a Dangerous Bilirubin Level in Newborns?
Treatment of Pathologic Jaundice
Phototherapy
Phototherapy is a common treatment. It uses light to break down bilirubin in the skin. This makes it easier for the baby’s body to excrete it.
Exchange Transfusion
In severe cases, an exchange transfusion is needed. This procedure replaces the baby’s blood with fresh blood. This removes the excess bilirubin.
Medications
Medications can be used to treat underlying causes. For example, antibiotics treat infections causing jaundice.
Monitoring and Support
Regular monitoring is essential. This ensures that bilirubin levels are decreasing. Supportive care, such as ensuring proper feeding, is also important.
Complications of Pathologic Jaundice
Kernicterus
Kernicterus is a serious complication. It occurs when bilirubin levels are very high. This leads to brain damage.
Hearing Loss
High bilirubin levels can cause hearing loss. Early treatment can prevent this.
Cerebral Palsy
Cerebral palsy is another complication. It affects movement and muscle tone. It can result from untreated high bilirubin levels.
Prevention of Pathologic Jaundice
Prenatal Care
Good prenatal care is important. This includes blood group screening for the mother. Early detection of Rh incompatibility can prevent jaundice.
Early Feeding
Early and frequent feeding helps. This encourages regular bowel movements. It helps excrete bilirubin from the body.
Monitoring High-Risk Newborns
Newborns at high risk should be monitored closely. This includes babies with blood group incompatibility or genetic disorders.
Conclusion
Pathologic jaundice is a serious condition. It requires immediate medical attention. Early detection and treatment are crucial. This prevents complications like brain damage. Parents should be aware of the symptoms. Regular monitoring and good prenatal care can prevent this condition. Always consult healthcare professionals if jaundice is suspected. They can provide appropriate care and treatment for the newborn.
FAQs
What Causes Jaundice Pathology?
Jaundice pathology is caused by an excess of bilirubin in the blood. This condition can arise due to several factors:
Blood Group Incompatibility: When the mother and baby’s blood types are incompatible, it can lead to the destruction of the baby’s red blood cells, causing an increase in bilirubin levels.
Genetic Disorders: Genetic conditions such as G6PD deficiency can lead to increased red blood cell breakdown, resulting in higher bilirubin levels.
Infections: Infections like sepsis in newborns can impair liver function, reducing its ability to process and excrete bilirubin.
Liver Disorders: Conditions such as biliary atresia, where bile ducts are blocked or damaged, prevent the normal excretion of bilirubin from the liver.
Hemolytic Anemia: Conditions that cause the rapid breakdown of red blood cells can also lead to excessive bilirubin production.
Prematurity: Premature babies often have immature livers that are less efficient at processing bilirubin.
What Are the Three Types of Jaundice?
Pre-hepatic Jaundice: This type occurs before bilirubin reaches the liver. It is often due to increased destruction of red blood cells (hemolysis), which overwhelms the liver’s ability to conjugate and excrete bilirubin. Causes include blood group incompatibility and genetic disorders like G6PD deficiency.
Hepatic Jaundice: This type is due to problems within the liver itself. It can be caused by liver infections (such as hepatitis), genetic liver diseases, or conditions that affect the liver’s ability to process bilirubin, such as biliary atresia in newborns.
Post-hepatic Jaundice: Also known as obstructive jaundice, this type occurs after bilirubin has been processed by the liver but cannot be excreted due to blockages in the bile ducts. Causes include gallstones, tumors, or congenital anomalies affecting the bile ducts.
Can Pathological Jaundice Be Treated?
Yes, pathological jaundice can be treated, and the approach depends on the underlying cause and the severity of the condition:
Phototherapy: This is a common treatment that uses blue light to break down bilirubin in the baby’s skin, making it easier for the body to excrete it.
Exchange Transfusion: In severe cases, an exchange transfusion may be necessary. This procedure involves replacing the baby’s blood with fresh blood to remove excess bilirubin.
Medications: If jaundice is caused by an infection, antibiotics or antiviral medications may be used. In cases of blood group incompatibility, intravenous immunoglobulin (IVIG) may be administered to reduce the need for exchange transfusions.
Surgical Intervention: For conditions like biliary atresia, surgical procedures such as the Kasai procedure can help restore bile flow from the liver.
Supportive Care: Ensuring proper hydration and nutrition helps support the baby’s liver function and overall health.
Monitoring: Continuous monitoring of bilirubin levels and the baby’s overall health is essential to manage and adjust treatment as needed.
Early detection and treatment are crucial to prevent complications such as kernicterus, a form of brain damage caused by very high bilirubin levels. Parents should seek medical attention promptly if they notice signs of jaundice in their newborn.
