Jaundice in a newborn : a diagnostic problem

Abstract

Neonatal jaundice and hyperbilirubinaemia are usually associated with hemolytic disease of the newborn due to rhesus incompatibility; that other causes have to be kept in mind in reaching a diagnosis is illustrated by a case study. A male child weighing 7 lb: 7 oz. was born in hospital and discharged in good condition. He was readmitted when 15 days old because of increasing jaundice of about one week's duration. On examination the baby was moderately jaundiced, with a temperature of 99.4 Fahrenheit, and a pulse rate of 120/min. From the findings it was concluded that the baby was suffering from a hemolytic anemia due to G6PD deficiency inherited from the mother. Jaundice in the newborn often presents diagnostic problems. A practical classification depending on the time of first appearance of the jaundice is given in Table 2. As the condition is being recognized more frequently, one should think of G6PD deficiency in places like Malta where the incidence of the deficiency is fairly high whenever a case of jaundice not due to rhesus-incompatibility arises. The avoidance of drugs and other substances that are known to cause hemolysis may then prevent fatal kernicterus and other complications of severe jaundice of the newborn.