Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Pediatrics

Backround: Routine use of transcutaneous bilirubin (TcB) measurement in the newborn nursery could reduce costs, readmission rates for hyperbilirubinemia and the need for total serum bilirubin (TSB) measurements. Objectives: To compare transcutaneous and plasma bilirubin measurements before, during and after phototerapy, on sternum (exposed), forehead and back (covered) areas, to verify the correlation between TSB and TcB levels in full term and preterm infants to use it as screening method for neonatal jaundice. Methods: A prospective cohort study was performed on 200 neonates with indirect hyperbilirubinemia, Simultaneous plasmatic and transcutaneous (frontal, sternal and back regions) (within 30 min) bilirubin assays were performed before, 12 hours after the beginning of phototerapy and 6 hrs after discontinuing photo. The association between the measurements and neonatal weight, sex, gestational and postnatal ages and the type of photo was calculated Results: we studied 169 terms and 31 preterms. TSB and TcB measurements of Pre-phototherapy, at 12 hours after the beginning of phototerapy and at 6 hrs after discontinuing photo, showed that there were strong correlations between TSB & TcB regardless to timing and site of measurements. No neonatal characteristics were significantly affected transcutaneous bilirubin measurements. Conclusion: Transcutneous bilirubinometry has demonstrated signi{uFB01}cant accuracy compared to TSB, so can be safely used for evaluation of bilirubin level in preterm and term infants, but take inconsideration pre-phototherapy more accurate over sternum and back, while during and after photo more accurate over covered areas (forehead and back)

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