Elevated bilirubin in the newborn: whatdo. Why is elevated bilirubin in the newbornbaby

ATт, 24 янв 2017 Автор: врач хирург, эндокринолог
Artyom Shimansky

The human body is a complex biochemical
the system. Everything in it is in constant motion and changes.
But, one way or another, the processes of the body are always in
dynamic equilibrium. Especially rightly said for
a man who was recently born. Pregnancy, childbirth and
everything connected with them is still covered with a halo of superstitious
mystery Meanwhile, new mothers care about issues
health of your child.

One of the possible questions that are asked mothers,
concerns increased bilirubin in the newborn.

It should be noted that all newborns have bilirubin.
increased and not always the reason for that

To understand the problem, first you need to know what
bilirubin, and then determine what causes it to increase

What is bilirubin and is it always a boost in a newborn?
talking about problems?

Билирубин представляет собой особое вещество,
bile pigment that is formed as a result of the breakdown of protein
substances. The concentration of this pigment in the blood reflects the work
the liver. However, not always an increase in bilirubin level
о патологиях у newborns. The thing is that during
finding a child inside the womb of an unborn person
I could not breathe on my own. Cellular respiration in the intrauterine
period occurs through blood. After birth extra
hemoglobin begins to be utilized by the liver and, as a result,
excess bilirubin is produced. This condition lasts from
several weeks to several months. If bilirubin is not
decreases, this is the basis for suspicion in the presence of certain

However, this is not an axiom. Bilirubin can be eliminated even
slower if one of the following factors exists:

• Prematurity. Premature babies have lower bilirubin
slower, medical care is often required for his

• The presence of a cold in the prenatal mother of the child

• The mother has a history of diabetes.

• Hypoxia (lack of oxygen) in a child.

• Asphyxia during labor.

In these cases, the so-called physiological
jaundice, when the pigment bilirubin is spread with blood to the eyes,
skin, etc.

Причины повышенного билирубина у newborns. Symptoms

Существует немало diseases, которые являются причинами
повышенного билирубина у newborns. In this case they talk about
pathological increase of the pigment substance in the blood. One of
The most likely causes of a pathological increase in a substance are
всевозможные заболевания the liver. According to medical statistics
every sixth newborn suffers from infectious lesions
the liver. From the entire list presented the probability of pathology
the liver is the highest. Symptoms этого состояния весьма

• Pain syndrome. Based on older children
age, you can say that the pain is pulling, aching, dull.
Localized in the right side. The child cannot speak, but his
behavior is typical: he often presses his legs to his stomach,
naughty, crying, can hold his hand pressed to the right

• Yellowing of the sclera and skin. May not be due
only physiological, but also pathological jaundice. To
make a diagnosis should pay attention to other symptoms.

• Увеличение размеров the liver. Determined by palpation.

• Unstable chair. Most often it is about diarrhea, either
alternating diarrhea and constipation.

• Changing the color and nature of the chair. For liver diseases
the chair looks like clay in texture and has no color
(white bleached chair).

При наличии этих симптомов велик риск наличия патологии
: она может быть инфекционной этиологии,
parasitic origin, etc. To understand this can only
the doctor after the diagnosis.

The next disease leading to increased bilirubin –
механическая желтуха. It arises as a consequence
obstruction of the biliary tract as a result of stenosis of the walls or as
total obstruction with stones. In this case, the symptoms are very similar to
симптомы инфекционного поражения the liver. Delimit them without
instrumental diagnostics is simply impossible.

Цирроз the liver. It is extremely rare in
children. However, it is more malignant.

Непроходимость кишечника может стать причиной
high concentration of bilirubin. In children, it occurs quite
often (about 3% of babies suffer from obstruction).

The main symptom of intestinal obstruction at an early stage –
pain syndrome. The child presses the legs to the stomach, constantly crying.
At the early stage it is easy to confuse obstruction with the banal intestinal
colic. A clear picture only becomes later, when
other signs of obstruction are also connected:

• Alternating constipation and diarrhea. In the end, formed
persistent constipation.

• Bloating, flatulence due to impossibility of normal
discharge of gases.

• In advanced cases of vomiting with blood and feces.

A chronic form is also possible, in which case the state is skillful.
�”Mimics” under the usual constipation.

Diseases associated with hormonal disorders: from
pituitary insufficiency before diabetes mellitus. In early
age is not easy to determine a specific disease.

Internal bleeding of varying intensity may become
cause increased bilirubin in the newborn.

The next reason lies in autoimmune processes during
which cells destroy red blood cells.

In addition, some temporary pathological conditions may
be triggered by the use of drugs,
used to speed up the birth process of the mother.

The most informative first 4 days from the moment of birth. If feces
discolored – this is a clear sign of liver and / or gallstones
the bubble.

Diagnosis with elevated bilirubin in the newborn

Diagnostic measures for elevated bilirubin begin
from visiting the doctor. The first who should show the child –
pediatrician. He will conduct an initial inspection and give the necessary
referral to a specialist –
врачу-гастроэнтерологу или гематологу.

At the initial examination, the doctor asks questions about complaints. Parents
should accurately and clearly tell what complaints are observed in the child,
and how they appear. Next, a specialist gastroenterologist conducts
physical examination – palpating the affected organ (liver,
intestines). Already at this stage, pathology can be suspected. Following
stage – laboratory tests. Among them:

• General blood analysis. Assigned to determine
leukocytosis, increased ESR. These figures give reason
suspect inflammatory process.

• Blood test for bilirubin. Specialized analysis
assigned to assess the indicator.

In the future, resort to instrumental studies:

• An ultrasound of the liver and digestive tract. This study gives
ability to visually assess the status of the digestive system

• MRI / CT, appointed in extreme cases, for example, when
suspected biliary obstruction, etc. Usually
enough ultrasound.

Based on these indicators, the doctor makes a diagnosis and
prescribes appropriate treatment.

Elevated bilirubin in the newborn, what to do? Treatment

In the case of the physiological nature of the increase in bilirubin, the response to
the question of what to do with elevated bilirubin in a newborn lies
on a surface. Do not need anything. With a protracted process
UV irradiation is assigned to accelerate it. AT
cases where the cause lies in the violation of the liver,
choleretic drugs are prescribed in the minimum dosage, as well as
hepatoprotectors. In no case should not give their drugs
a child without consulting a specialist. It is fraught.

AT крайних случаях (при непроходимости кишечника, при обструкции
biliary tract) is assigned urgent prompt
intervention. But, fortunately, such situations are rare in
medical practice.

Increased bilirubin in newborns can be as
natural and pathological. Only they can be delimited.
experienced doctor based on diagnostic data

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