الفهرس 
Introduction and aim of the workOnly 14 pages are availabe for public view
 |  | from | 69 |  |  |
| | | from | 69 | | |
Abstract
Summary
Jaundice occurs in most newborn infants. Most jaundice is benign, but because of the potential toxicity of bilirubin, newborn infants must be monitored to identify those who might develop severe hyperbilirubinemia and, in rare cases, acute bilirubin encephalopathy or kernicterus.
The study was designed to examine the possible correlation between umbilical cord bilirubin levels and serum bilirubin developed at the third day of life and if possible usage of cord blood as a predictor for neonatal hyperbilirubinemia and subsequent phototherapy.
The present study included 50 healthy, term newborns, selected from El-Tal Elkeber Hospital in the period from June2013 to October 2013.
All included neonates were subjected to the following full history taking, ,clinical examination and laboratory investigation with stress on the serum and cord bilirubin levels.
The results of the study revealed that
- Jaundice was apparently present in 30 cases (60%). from those 30 cases only 11 cases needed treatment (36.7%). Those 11 cases represent (22%)from all patients included in the study.
- In cases with overt jaundice, the cord level of indirect bilirubin was ranged from 0.60 to 3.50 with a mean of 1.68 ± 1.02 mg/dl and serum level was ranged from 4.90 to 18.10 mg/dl with a mean of 9.98 ± 4.26 mg/dl and there was statistically highly significant increase in serum level in relation to cord level.
- In neonates with significant clinical jaundice(11 neonates out of 30) needed treatment , cord indirect bilirubin was ranged from 2.3 to 3.5 with amean of 2.91±0.38 mg/dl with serum bilirubin ranged from17to 18.1with amean of 17.53±0.43 mg/dl and there was statistically highly significant increase in serum level in relation to cord level.
- There was powerful (r > 0.7) proportional (the value of r is positive),statistically highly significant correlation between cord blood indirect bilirubin levels and serum levels of indirect bilirubin measured at the third day in cases developed clinical jaundice.
- In neonates with significant clinical jaundice(11 neonates out of 30) needed treatment , there was moderate, proportional, statistically highly significant correlation between cord and serum indirect bilirubin levels.
- Regarding the probability of subsequent significant neonatal jaundice that would require treatment for each value of indirect bilirubin in cord blood that was equal to or greater than 2.6 mg/100ml. thus, when the indirect bilirubin in cord blood was 2.7 mg/dl, the probability of subsequent significant neonatal jaundice needing treatment was 72.0%; when the level was 3.3 mg/dl, the probability was 86%, and if it was 3.5 mg, the probability went up to 92%.
- Indirect cord bilirubin level of 2.6 mg/dl was highly specific but less sensitive in prediction of significant neonatal jaundice requiring treatment later on, but indirect cord bilirubin level of 3.5 mg/dl had highest sensitive, specificity and accuracy (100%) and can predict nearly all of the term newborns who will have significant hyperbilirubinemia and will determine all those who will require a treatment later during the first days of life.