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Subject:
From:
Lynn Shea <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Thu, 2 Oct 2003 11:51:12 EDT
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check this out

In the eye of the beholder: how accurate is clinical estimation of jaundice
in newborns?

Riskin A, Kuglman A, Abend-Weinger M, Green M, Hemo M, Bader D.

Department of Neonatology, Bnai Zion Medical Center, The B Rappaport Faculty
of Medicine, Technion, Israel Institute of Technology, Haifa, Israel.
[log in to unmask]

AIM: Hour-specific serum total bilirubin (STB) percentiles have proved useful
in predicting which babies will develop significant neonatal
hyperbilirubinemia (NHB) requiring intervention. This study investigated whether this
assessment could be performed visually instead of by blood test. The aim was to
evaluate the ability of experienced clinicians to determine accurately the level of
clinical jaundice in neonates by visual means. METHODS: Four neonatologists
were asked to estimate the level of bilirubin in a group of 283 term clinically
jaundiced infants before discharge from the nursery on day 3 of life. Their
clinical estimation was compared with actual measurement of STB from samples
drawn simultaneously. RESULTS: Clinical estimation of STB had a high correlation
to actual serum bilirubin levels (Pearson's correlation coefficient = 0.682, p
< 0.001). CONCLUSION: Clinical impression of jaundice by the eye of an
experienced clinician is a reliable method to assess newborns for significant NHB
and may diminish the need for universal serum sampling.

Lynn Shea

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