الفهرس 
AbstractOnly 14 pages are availabe for public view
 |  | from | 154 |  |  |
| | | from | 154 | | |
Abstract
Hyperbilirubinema is the most commen condition requiring evaluation and treatment in new borns (Robin and woston 2009).
Early discharge has been associated with siginificant hyperbilirubinemia particularly during 1st week of life . The early the discharge without outpatient follow-up, the greater the propability of more jaundice cases going unnoticed by family members (fernado perazzini e t al,2007).
Alpay et al., (2000) made a prospective study to identify the newborns at risk for developing significant hyperbilirubinemia later during the first days of life by measuring the serum bilirubin levels of the first 5 days of life to determine the critical predictive serum bilirubin value on the first day of life.
Sarici et al., (2002) in his study determined the critical serum bilirubin level to predict significant hyperbilirubinemia and severe hemolytic disease in healthy term newborns with ABO incompatibility.
Also Agarwal et al. , (2002) evaluated the predictive value of 1st day serum bilirubin in identifying near term and term infants, who do not develop hyperbilirubinemia.
During the 1990 ,jaundice was the most frequent reason for readmission after early hospital discharge .kernicterus has been described in a small subset of these infants (Maisels and newman,1998).
Today hospital discharge at 24 hours is comman ,leading to fewer obesvations by professionals at a time when jaundice may just be at the threshold of visibility (Poland 2002) .
For these reasons ,early identification of newborn infants at risk for develoing severe hyperbilirubinemia and possible bilirubin induced neurologic dysfunction has become a public health issue(Bhutani et.al,2002) .
The aim of this study was to evaluate the predictive value of TSB measurement on 1st day of life in identifying term infant at risk for developing significant hyperbilirubinemia during the early day of life .
One hundred of full healthy neonates were included in this study with gestational age ranging from 37 to 41 weeks. All of them were clinically free ,exclusively breast-fed and out of RH hemolysis .
Significant hyperbilirubinemia occurred in one infant .
A TSB of ≤ 6.5 mg/dl in 1st day of life was present in 91 infants and non of theme develop significant hyperbilirubinemia. only one case with TSB 6.9mg/dl in 1st day developed significant hyperbilirubinemia.
So we can conclude that :-
1- TSB < 6.5 mg/dl in 1st day of life predict neonates who will not be developed significant hyperbilirubinemia . Yet further investigation are recommended to evaluate if neonates with TSB > 6.5mg/dl will develop significant hyperbilirubinemia or not .
2- There was positive correlation between age of baby during investigation and 1st day TSB level .
3- There was positive correlation between parity and 1st day TSB level .
4- There was insignificant relation between gestational age,body weight and 1st day TSB level .
5- sex,maternal disease,type of labour and history of jaundice among siblings have no significant effect on 1st day TSB level .
Prediction of neonatel hyperbilirubinemia should have widespread implication especially in our country where there are limited resources and few hospitals . Infants at low risk for hyperbilirubinemia can be discharged early from the hospital ,and those at risk need close observation using non-invasive measures like bilirubin measurement in follow up visits .