Nuclear jaundice of newborns: symptoms, effects and treatment

Nuclear jaundice occurs in every third newborn baby. This abnormal icteric condition of the skin arises from the excessive release of a substance such as bilirubin.

In the normal state, the decomposition of hemoglobin and the production of bilirubin occur in the newborns' body, but a failure can 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 exposure of bilirubin to the brain and the nervous system can be determined from the concentration of the substance in the blood. At a critical mark of 425 μmol, a disease called nuclear jaundice of newborns occurs. This applies only to full-term children. If the birth occurred before the deadline, the indicative mark is reduced. In this case, the decrease in the mark is affected by intrauterine fetal hypoxia and various infections.

In addition, the incompatibility of the blood of the infant and mother is a provoking factor in the development of nuclear jaundice. There is a conflict of Rh-factors of blood.

Why does the body accumulate bilirubin

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

In newborn children, the liver is weak, which means that processing slows down. As a result, the pigment gradually accumulates, not having enough time to reprocess, there is a nuclear jaundice. The consequences of this disease are serious.

Preterm 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 - premature babies with a small body weight at birth are not fully developed internal organs, so the process of processing bilirubin is slowed. Nuclear jaundice is observed in 80% of the births of premature babies.

Symptoms of the disease

The disease develops within one week. If the hemolytic jaundice has already developed in the baby, then the outward appearance of the disease manifests itself after a day.

If the development of nuclear jaundice of newborns, the symptoms that give it out may be as follows:

• Sharp deterioration of the general condition of the baby.
• The child has convulsive conditions or apnea.
• External examination indicates the presence of hypertonic muscle.
• A distinctive feature of nuclear jaundice is a sudden tilting of the head back.
• With a further undetected course of the disease, mental underdevelopment is observed.
• The clinical symptoms of a nuclear jaundice may indicate a brain damage to a newborn.

The onset of nuclear jaundice: causes

The main causes of the disease include:

• The conflict between the Rh factor in the blood of the baby and the mother, that is, the blood group is not combined.
• Lack of a vitamin in the body of a newborn such as vitamin K, as well as the effect on the fetus of certain medications used by the mother during pregnancy.
• Generic hematomas in the baby.
• Lack of oxygen for the fetus or wrong metabolism.
• Genetic predisposition.
• Insufficient development of internal organs.

When excessive production of bilirubin in children, the jaundiced color of the skin is observed. The symptoms of nuclear jaundice are practically the same for all. It is enough to examine the child according to the rule of Cramer: with jaundice, the hands, feet and belly of the newborn have an abnormal yellow color.

Consequences of nuclear jaundice

The consequences of the disease can be different, it's all about the healing time and the development of nuclear jaundice. There may be development of encephalopathy, and in advanced cases, partial deafness and blindness. In addition, in the absence of timely treatment, the risk of brain damage increases, which is the gravest consequence of nuclear jaundice.

With brain damage, 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 deny the diagnosis.

Qualified help

Several years ago, glucose and other ineffective drugs were used to treat nuclear jaundice. In modern medicine, the most commonly used method is phototherapy - the impact on the body of a newborn certain radiation emanating from a special lamp. Due to radiation, bilirubin becomes less toxic and is removed from the body naturally, that is, with urine and feces.

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. When excessive amounts of substance are prescribed special drugs that accelerate the process of removing the toxic pigment. If the child is in a group at increased risk, then an internal one-stage plasma injection is performed.

If the nuclear jaundice increases, then drip infusion of plasma together with phototherapy. In the absence of improvement, it is necessary to resort to a complete blood transfusion.

In the presence of nuclear jaundice the child is under the supervision of a neurologist. It is this specialist that performs rehabilitation therapy that helps to restore impaired functions.