Jaundice of the Newborn

Jaundice of the Newborn 

the appearance of yellow coloring of the skin and mucous membranes in infants during the first days of life, as a result of a disturbance of bilirubin metabolism.

In healthy infants, physiological jaundice of the newborn arises because of immaturity of the liver’s enzyme systems. Genetically caused (hereditary) enzymopathies, such as transitory familial hyperbilirubinemia, are also found. Jaun-dice of the newborn may appear because of intensified decomposition of erythrocytes: congenital (hereditary) hemolytic jaundice of the newborn. This occurs as the result of a change in the erythrocytes (microspherocytosis), which become more readily subject to destruction (the Minkovskii Chauffard syndrome, named for physiologist O. Minkovskii and the French physician A. Chauffard, who described this pathology in 1900). There are also jaundices that occur with massive hemorrhage at parturition (such as cephalohematoma and retroperitoneal hematoma), during acute and chronic infections of bacterial or viral origin, when there is a congenital deficiency of glucose-6-phosphate dehydrogenase, which participates in bilirubin metabolism. Hemolytic disease of the newborn, which arises when there is an incompatibility between the blood of the mother and that of the child, also causes jaundice in infants. Jaundice of the newborn may be caused by the mechanical arrest of bile (for example, congenital atresia of bile-excreting pathways or tumors of the liver and pancreas) or by affection of the parenchyma of the liver (in connection with diseases such as hepatitis, cytomegaly, sepsis, syphilis, and toxoplasmosis). Treatment is applied according to the cause. Physiological jaundice of the newborn requires no treatment.

REFERENCES

Tabolin, V. A. Bilirubinovyi obrnen i zheltukhi novorozhdennykh. Moscow, 1967.
Grigler, J. F., and V. A. Najjar. “Congenital Familial Nonhemolytic Jaundice with Kernicterus.” Pediatrics, 1952, vol. 10, no. 2. pp. 169–80.

M. IA. STUDENIKIN and R. N. RYLEEVA