الفهرس 
Chapter 1: Neonatal jaundiceOnly 14 pages are availabe for public view
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Abstract
Phototherapy is the first line of treatment of unconjugated
hyperbilirubinemia to reduce the serum level of unconjugated bilirubin levels.
Phototherapy though safe, is not free of side effects. Neonates receiving
phototherapy have increased insensible water loss redistribution of blood flow,
watery diarrhea, irritability, rise in temperature, retinal damage, bronze baby
syndrome, gonadal toxicity, impaired maternal-infant interaction, hypocalcaemia,
riboflavin deficiency, DNA strand breakage, chromosomal mutations damage, and
in few studies even thrombocytopenia.
The present study was conducted on 100 full-term neonates who were
subdivided into 2 groups: 50 control jaundiced neonates with indirect
hyperbilirubinemia who did not receive phototherapy & 50 jaundiced neonates
(26 males & 24 females) received phototherapy for treatment of physiological
neonatal indirect hyperbilirubinemia. These neonates include full-term > 37wk.
Cases was selected from those admitted to NICU of Menoufia University Hospital
and El-Sadat Hospital.
All study neonates were subjected to thorough history taking, Full clinical
examination. Baseline investigations which done before phototherapy include
Complete Blood Count, Serum Total & direct bilirubin level, blood grouping &
Rh for infant & mother and C-Reactive Protein to exclude sepsis. Follow up for
clinical data and Laboratory investigation (CBC, serum total and direct bilirubin
level) after 48 Hrs. and after 72 hours‘ phototherapy.
There was highly statistically significant decrease in platelet count in cases
group after 72 Hrs. compared to 48 Hrs. compared to its level at admission.
There was a statistically high significant positive correlation between
platelet count after 48 hours of admission and gestational age in cases group.
There was a statistically high significant negative correlation between
platelet count after 72 hours of admission and type of delivery in cases group.
There was statistically significant decrease in CS delivery group compared
to normal delivery in cases group concerning platelets count after 72 Hrs.
The incidence of thrombocytopenia in case group after 72 hours of
admission is 10%.
As we found in our study, when selecting 148.5000 cutoff point of platelet
count after 72 hours showing best cutoff point of incidence of thrombocytopenia
in the studied groups patients with platelet count less than 148.5000 are more
likely to have thrombocytopenia, as 74.0% of them were diagnosed as actual
thrombocytopenia (sensitivity). The proportion of actual negatives that are
correctly identified as negative platelet count more than 148.5000 is 100%
(specificity). Platelet count can separate well the tested group into those with and
without thrombocytopenia.
There was no statistical difference between thrombocytopenia cases and
normal platelet count in cases group, except for total bilirubin was significant
statistically decreased in thrombocytopenia cases.