Nuclear jaundice in newborns: symptoms, consequences and treatment

2024 Author: Priscilla Miln | [email protected]. Last modified: 2023-12-16 00:21

Nuclear jaundice occurs in every third newborn baby. This abnormal icteric skin condition occurs due to excessive secretion of a substance such as bilirubin.

Under normal conditions, hemoglobin breakdown and production of bilirubin occurs in the body of newborns, but a failure may occur in which the liver is unable to process all the bilirubin formed. A harmful substance enters the blood, badly affecting the cells of the body and the nervous system. Bilirubin has a nuclear influence, which is why the disease got its name.

Pathogenesis and etiology of the disease

The degree of influence of bilirubin on the brain and nervous system can be determined by the concentration of the substance in the blood. At a critical level of 425 µmol, a disease occurs called nuclear jaundice in newborns. This applies only to full-term babies. If the birth occurred prematurely, then the indicative mark decreases. In this case, intrauterine hypoxia of the fetus and various infections affect the lowering of the mark.

In addition, the incompatibility of the blood of the baby and the mother is a provoking factor in the development of kernicterus. There is a conflict of Rh factors in the blood.

Why in the child's bodybilirubin accumulates

Bilirubin is a substance that appears as a result of the processing of hemoglobin in the child's body. There are two forms of a substance: soluble and insoluble. Forms of bilirubin have a certain ratio in the body, which is considered normal, this is 1 to 3. The liver processes the insoluble form of the substance into a soluble one, which is removed from the body naturally with urine and feces.

In newborns, the liver is weak, which means that processing slows down. As a result, the pigment gradually accumulates, not having time to be processed, nuclear jaundice occurs. The consequences of this disease are serious.

Term and prematurity of children also affects the critical mark of the amount of bilirubin in the blood. The difference is up to 100 µmol. This difference is due to the physical condition of the newborn - in premature babies with low body weight at birth, internal organs are not fully developed, so the process of processing bilirubin is slowed down. 80% of preterm infants are born with kernicterus.

Symptoms of disease

Illness develops within one week. If hemolytic jaundice has already developed in a baby, then outwardly the disease manifests itself after a day.

If kernicterus develops in newborns, symptoms that give it away may be as follows:

• A sharp deterioration in the general condition of the baby.
• Child has seizures or apnea.
• External examination indicates the presence of muscle hypertonicity.
• The hallmark of kernicterus is the sudden tilting of the head back.
• With further undiagnosed course of the disease, mental underdevelopment is observed.
• Clinical symptoms of kernicterus may indicate damage to the brain of the newborn.

Occurrence of nuclear jaundice: causes

The main causes of the development of the disease include:

• The conflict between the Rh factors of the blood of the baby and the mother, that is, the blood type does not match.
• Lack of vitamin K in the newborn, as well as the effect on the fetus of certain drugs used by the mother during pregnancy.
• Birth hematomas in a baby.
• Lack of oxygen for the fetus or improper metabolism.
• Genetic predisposition.
• Insufficient development of internal organs.

With excessive production of bilirubin in babies, an icteric color of the skin is observed. The symptoms of kernicterus are almost the same for everyone. It is enough to examine the child according to Cramer's rule: with jaundice, the hands, feet and stomach of a newborn have an abnormal yellow color.

Consequences of nuclear jaundice

The consequences of the disease can be different, it's all about the time of cure and the time of development of kernicterus. There may be development of encephalopathy, and in advanced cases, partial deafness and blindness. In addition, in the absencetimely treatment increases the risk of brain damage, which is the most severe consequence of kernicterus.

When the brain is damaged, children are inhibited, weak, do not respond to stimuli and even the voice of their parents.

When identifying the first signs of jaundice, you need to seek help from a specialist who will help confirm or refute the diagnosis.

Qualified help

Several years ago, glucose and other ineffective drugs were used to treat kernicterus. In modern medicine, the method of phototherapy is most often used - the effect on the body of a newborn of certain radiation emanating from a special lamp. Radiation makes bilirubin less toxic and is eliminated from the body naturally, i.e. in urine and feces.

In order to avoid the terrible consequences of nuclear jaundice, after the birth of the baby, blood is taken for analysis. Studies are conducted to determine the amount of bilirubin in the baby's blood. With an excessive amount of a substance, special preparations are prescribed that accelerate the process of removing toxic pigment. If the child is at high risk, then an internal single-stage injection of plasma is performed.

If kernicterus worsens, then a plasma drip infusion is performed in conjunction with phototherapy. If there is no improvement, a total blood transfusion should be considered.

In the presence of kernicterus, the child is under the supervision of a neurologist. It is this specialistprovides rehabilitation therapy to help restore impaired functions.