Interscapular Site for Transcutaneous Bilirubin Measurement in Neonates
Mai Gamal Abd Elaziz El Mahdy;
Abstract
Summary
J
aundice is the visible manifestation of hyperbilirubinemia and the most frequently encountered problem in newborns.
Our high crude birth rate and high hospital occupancy rate in Egypt necessitates early discharge of healthy term neonates before 48 h of life. Because TSB has not yet peaked by this time, there is a potential for post-discharge hyperbilirubinemia.
The conventional methods of measuring TSB require blood sampling, which cause pain to infants and repeated blood sampling is associated with risk of infection and scar formation. Depending on the location of laboratory services, there may be delay before TSB results are available to start treatment. Since late 70s measuring the bilirubin by transcutaneous biliurbinometry became an applicable, easy and non-invasive method for measuring bilirubin as many times as needed.
Our study investigated the correlation of TcB levels with TSB levels with the intent of using TcB as a screening tool for clinically significant neonatal hyperbilirubinemia, and to detect the accuracy of TcB measurement from interscapular site, sternum and forehead in relation to TSB level.
This study was a cross sectional study of 100 neonates (50 term and 50 preterm neonates) with clinically apparent jaundice who otherwise appear healthy. It was carried out at the Neonatal Intensive Care Unit (NICU) of Gynecology and Obstetric Hospital, Ain Shams University.
Each patient included in this study was subjected to thorough history taking, careful clinical examination, laboratory investigations, analysis of the therapy received and analysis of the outcome.
In all patients transcutaneous bilirubinometery readings were obtained from the forehead, sternum and interscapular area using Konica Minolta/Air Shields JM 103, Jaundice Meter (JM103). At the same time a venous sample was collected for estimation of serum bilirubin level using the method of direct spectrophotometer in laboratories of Ain Shams University Maternity Hospitals.
The results of this study revealed that:
1. There is a significant linear relationship between transcutaneous bilirubinometery and serum bilirubin concentration in all three sites in all included neonates irrespective to gestational age, sex, body weight, postnatal age and mode of delivery.
2. The interscapular TcB has the highest sensitivity in identifying study participants in need of phototherapy and the lowest false negative rate. While the chest was the poorest site of choice.
J
aundice is the visible manifestation of hyperbilirubinemia and the most frequently encountered problem in newborns.
Our high crude birth rate and high hospital occupancy rate in Egypt necessitates early discharge of healthy term neonates before 48 h of life. Because TSB has not yet peaked by this time, there is a potential for post-discharge hyperbilirubinemia.
The conventional methods of measuring TSB require blood sampling, which cause pain to infants and repeated blood sampling is associated with risk of infection and scar formation. Depending on the location of laboratory services, there may be delay before TSB results are available to start treatment. Since late 70s measuring the bilirubin by transcutaneous biliurbinometry became an applicable, easy and non-invasive method for measuring bilirubin as many times as needed.
Our study investigated the correlation of TcB levels with TSB levels with the intent of using TcB as a screening tool for clinically significant neonatal hyperbilirubinemia, and to detect the accuracy of TcB measurement from interscapular site, sternum and forehead in relation to TSB level.
This study was a cross sectional study of 100 neonates (50 term and 50 preterm neonates) with clinically apparent jaundice who otherwise appear healthy. It was carried out at the Neonatal Intensive Care Unit (NICU) of Gynecology and Obstetric Hospital, Ain Shams University.
Each patient included in this study was subjected to thorough history taking, careful clinical examination, laboratory investigations, analysis of the therapy received and analysis of the outcome.
In all patients transcutaneous bilirubinometery readings were obtained from the forehead, sternum and interscapular area using Konica Minolta/Air Shields JM 103, Jaundice Meter (JM103). At the same time a venous sample was collected for estimation of serum bilirubin level using the method of direct spectrophotometer in laboratories of Ain Shams University Maternity Hospitals.
The results of this study revealed that:
1. There is a significant linear relationship between transcutaneous bilirubinometery and serum bilirubin concentration in all three sites in all included neonates irrespective to gestational age, sex, body weight, postnatal age and mode of delivery.
2. The interscapular TcB has the highest sensitivity in identifying study participants in need of phototherapy and the lowest false negative rate. While the chest was the poorest site of choice.
Other data
| Title | Interscapular Site for Transcutaneous Bilirubin Measurement in Neonates | Other Titles | قياس البيليروبين عبر الجلد بمنطقة ما بين الكتفين في الأطفال حديثي الولادة | Authors | Mai Gamal Abd Elaziz El Mahdy | Issue Date | 2016 |
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