Elevated bilirubin were associated with hemolysis of red blood cells and the subsequent integration of unconjugated bilirubin from the intestine. This condition can be benign or risk of various complications of the child / unintended consequences instead.


Drowsiness, lethargy


Can not find, which means anemia
Living at an altitude of 5000 m
Cardiomegaly, increased bleeding tendency (fetal hydrops)


Hypoactive bowel sounds.
Meconium passage may be delayed.
Relief may be lost / green brown for bilirubin excretion.
Urine dark, concentrated, black and brown (bronze baby syndrome).

Food / Fluid

History of delayed / poor nutrition, poor sucking reflex.
This is more likely to breastfeed than formula.
Abdominal palpation may reveal enlarged spleen liver.
General edema, ascites (hydrops fetalis).


Large cephalhematoma can be seen in one or both legs parietal associated with birth trauma and exhaustion delivery.
The loss of the Moro reflex can be recorded.
Opisthotonos rigid curvature of the spine, bulging fontanelle, high crying, seizure activity (crisis phase).


History of choking
Cracked, pink-tinged mucus (pleural edema, pulmonary hemorrhage)


History may be positive for infection / neonatal sepsis.
Maybe too many bruises, petechiae, intracranial bleeding.
It seems at first a person with hepatitis transition to the distal part of the body, brown-black skin color (bronze baby syndrome), as a side effect of phototherapy.


It may be premature, the growth of the baby baby baby growth or IUGR, such as IDM.
Birth Trauma can occur in relation to cold stress, asphyxia, hypoxia, acidosis, hypoglycemia, hypoproteinemia.
It is more common in men than in women, children.

Education and training

Perhaps congenital hypothyroidism, biliary atresia, cystic fibrosis (inspissated bile)
Family factors such as ethnicity (Asian, Greek, or Korean), history of previous pregnancies bilirubienmetings / siblings, liver disease, cystic fibrosis, inherited metabolic disorders (galactosemia), blood disorders (spherocytosis, glucose-6 - phosphate dehydrogenase [G- 6-PD] deficiency)
Maternal factors such as maternal diabetes drugs (eg salicylates, sulfonamides, oral in the late stage of pregnancy or nitrofurantoin [Furadantin], Rh / ABO incompatibility, infectious diseases (eg rubella, CMV, syphilis, toxoplasmosis)
Intrapartum factors such as premature birth, delivery, suction oxytocin input, delayed umbilical cord clamping, or traumatic delivery

Diagnostic tests

Coombs test newborn cord blood: a positive indirect Coombs test indicates the presence of Rh-positive, anti-A and anti-B antibodies in the blood of his mother. Positive direct Coombs test result indicates the presence of sensitive (Rh-positive, anti-A and anti-B), red blood cells in newborns.
Child and maternal blood: Determination of ABO incompatibility.
Total bilirubin: Direct (conjugated) levels is important if you have more than 1.0 to 1.5 mg / dL, may be associated with sepsis. Indirect (unconjugated) levels should not exceed an increase of 5 mg / dL at 24 hours, if not more than 20 mg / dl in full-term baby, or 15 mg / dL in premature babies (depending on weight). Umbilical cord blood bilirubin 5 mg / dl, means a severe hemolysis.

Total serum protein: level <3.0>

1st Injury Prevention / condition progression.
2nd We offer support / appropriate information to relatives.
Exemption Criteria:
The first maintenance of physiological homeostasis of bilirubin decrease.
Second prevention of complications resolved.
Parents third (and) understands the condition / prognosis and treatment.
4th Plan in place you need after discharge.

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