What tests are needed for neonatal pathological jaundice?

What tests are needed for neonatal pathological jaundice?

1 Routine blood test, reticulocyte count and nuclear red blood cell count.

2 Determine the total bilirubin and direct bilirubin. The serum bilirubin is 205 μmol/L for full-term infants and 12 mg/dl for premature infants; 256 μmol/L and 15 mg/dl for children. Be alert to the occurrence of bilirubin encephalopathy in children.

3. Urinalysis and urine tricholine test.

4 Pay attention to the color of urine and feces, and perform a fecal examination if necessary.

5. Choose the following tests according to your condition:

① For those suspected of neonatal hepatitis, the liver function of both mother and child should be checked for HB-sAg, HBeAg, HBVDNA, anti-HBc-IgM, etc. If the alpha-fetoprotein is normal, the alpha-fetoprotein of the newborn is positive and turns negative one month after birth.

② Blood culture is performed on patients with suspected neonatal sepsis, and local infection exudate is used for smear and culture.

③ In case of suspected cytomegalovirus inclusion disease, giant cells with inclusion bodies are found in urine sediment examination, and virus isolation and serological examination can be performed if conditions permit.

④ Suspected neonatal hemolytic disease, see neonatal hemolytic disease for details.

⑤ For patients suspected of erythrocyte G6PD deficiency, the reduction rate of methemoglobin is >75% of that of normal people; the Heinz body formation test of denatured globin bodies is performed; if conditions permit, the G6PD activity is measured.

⑥ Red blood cell fragility test: In patients suspected of having hereditary spherocytosis, the initial hemolysis is 0.40% to 0.46% for normal people, and the complete hemolysis is 0.30% to 0.36%. The red blood cell fragility of patients is increased.

⑦ For suspected galactosemia, urine Benedict's test can be performed. If conditions permit, the blood galactose concentration and red blood cell galactose-1-phosphogydase activity can be measured.

⑧ Suspected α1-antitrypsin deficiency Serum protein electrophoresis examination Patients with antitrypsin deficiency α1-globulin

⑨ In case of suspected congenital biliary obstruction, attention should be paid to the dynamic changes of blood bilirubin and stool color. If necessary, lipoprotein X test, B-type ultrasound, CT and other examinations should be used.