Patient's question:
The baby has had jaundice since birth. After being checked in the neonatal department, the doctor said it was pathological jaundice and recommended exposure to ultraviolet light. The child is expected to naturally recover from jaundice as they grow, but now it has been more than a month, and the jaundice has not subsided. What kind of help is needed: How to deal with pathological jaundice in newborns?Doctor's answer:
Physiological jaundice generally appears on the second or third day after birth. If jaundice occurs within 24 hours, with a level exceeding 6 milligrams per deciliter, and if this threshold is surpassed on the first day, it is considered pathological. Thereafter, the level of bilirubin in the blood: for full-term infants, the previous threshold was 12.9 milligrams per deciliter, and the current international unit is 220 micromoles per liter. If it does not exceed this value, it is considered normal and physiological; if it exceeds this value, it is pathological. For premature infants, the threshold is slightly higher at 15 milligrams per deciliter. If it is below this value, it is physiological; if it exceeds this value, it is pathological.As mentioned earlier, one factor is the time of birth, and the other is the high level of bilirubin in the blood. The third factor is the rate of increase. If the increase reaches 5 milligrams per deciliter within 24 hours, it is also pathological. The fourth factor is the duration. Generally, jaundice should subside within a certain period—about half a month for premature infants, and around 10 days for full-term infants. If it persists for more than two weeks, it is pathological. Another situation to consider is when jaundice subsides and then reappears—this recurrence is also abnormal.
The fifth factor involves the increase in either direct bilirubin or indirect bilirubin. Bilirubin that has not been conjugated with glucuronic acid is called indirect bilirubin, also known as unconjugated bilirubin. Bilirubin that has been conjugated with glucuronic acid is called direct bilirubin. If the level of direct bilirubin exceeds 1.5 milligrams per deciliter, it is also indicative of pathological jaundice.
From these five aspects, a boundary is drawn: below this boundary, jaundice is physiological; above it, it is pathological. There are generally four common types of jaundice: hemolytic jaundice, which occurs when there is excessive hemolysis.