Types zheltushki newborns

Jaundice occurs in all infants and is not dangerous phenomenon. But in some cases, it is strongly expressed and it lasts longer than usual. Such a condition requires treatment - toxic products of metabolism are excreted by means of intravenous administration of the child plenty of fluids, or exposure to light.

Conjugation jaundice

Conjugation jaundice caused by violation of the binding process bilirubin. Bilirubin is a pigment of blood, which is produced by the decay of hemoglobin (the protein with iron compounds) erythrocytes in aging Internal and external aging: it is necessary to think in advance   and the decay of the past. Because hemoglobin is formed first indirect (free) bilirubin, which is concentrated in the liver under the influence of enzymes transformed into a straight line (associated with glucuronic acid) bilirubin. Direct bilirubin and the remaining small amount of indirect bilirubin in the bile enter the intestine and then excreted in the feces.

When conjugation jaundice observed lack of activity of enzymes with the aid of which the converting indirect bilirubin into direct and protein deficiency, which provides transport of bilirubin through the membranes of liver cells. As a result, the body of a newborn baby is an accumulation of indirect bilirubin in the absence of the collapse of the power of normal red blood cells (hemolysis). In addition, the newborn baby after birth decomposes large amounts of red blood cells containing fetal hemoglobin, which carries oxygen to the body's tissues during fetal development. After birth, the hemoglobin breaks down, as it becomes unnecessary.

By conjugation form of jaundice include physiological neonatal jaundice, jaundice of prematurity and some other species.

Physiological neonatal jaundice

Physiologic jaundice develops in most children no earlier than 36 hours of life, often on the third day. First icteric staining appears on the head, then extends to the body, arms, legs, eyes, and all conjunctival mucosa. At 4-6 day maintenance of indirect bilirubin in the blood reaches a maximum value and then begins to decline gradually. Yellowness gradually decreases and disappears (1-2 weeks). The general condition of the child at the physiological jaundice is not broken, but if it is highly expressed, the child becomes lethargic, is not breastfeeding, burp, is sometimes vomiting. On the severity of jaundice is judged not by appearances, and the level of bilirubin in the blood. Treatment of the physiological jaundice is not carried out. But in severe prolonged jaundice it is recommended intravenous infusion of 5% glucose, blood substitutes or phototherapy.

Jaundice of prematurity

Jaundice in preterm infants is more dangerous than in full-term. Staining of the skin and mucous membranes when it is more intense and prolonged. Number of indirect bilirubin in the blood reaches its peak at 5-6 days, jaundice lasts up to a month or more.

At very high levels of bilirubin in the blood may result in the brain, a condition called kernicterus (stained nuclei of the brain), but it may not be even at very high concentrations. It depends on the distribution of indirect bilirubin in the body and its activity while it penetrates the vessel wall (e.g., in brain tissue). Signs of kernicterus: severe lethargy, decreased sucking reflex, convulsions. In the future, these children can result in severe damage to the central nervous system in the form of paralysis, the backlog in the neuropsychological development, blindness, deafness, and so on.

Number of indirect bilirubin in the blood of a premature baby is not dependent on birth weight, it depends on the degree of maturity of the fetus and the mother of the disease during pregnancy.

Prolonged severe jaundice premature requires active treatment with drugs, phototherapy (fluorescent light) and at a high rate of accumulation of indirect bilirubin in the blood - exchange transfusion.

The most common and effective treatment of physiological jaundice of prematurity is now recognized phototherapy. Irradiation of babies with special lamps bilirubin is converted into non-toxic metabolites which are then excreted in the feces and urine. Houses such a child is recommended to "show" the scattered rays of the sun.

Excretion of bilirubin from the body, frequent of breastfeeding, as occurs during breast emptying of the gallbladder (the bile output bilirubin).

Any special condition of a newborn baby requires careful monitoring, which is why in the first month of his life every week visiting a pediatrician.

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