Estimation of hyperbilirubinemia by observation of neonate skin withjaundice in Amiralmomenin’s hospital of Semnan, 1999

Introduction. Jaundice is observed during the Ist week of life in approximately 60% of term and 80% of preterm infants. Jaundice us ually begins on the face and, as the serum level increases, progresses to the abdomen and th en the feet. The cephalocaudal progression of dermal icterus may be a useful clinical tool to estimate th e serum level of bilirubin. The aim of thi s study was to estimate hyperbilirubinemia by observation of neonate skin with jaundice in Amiralmomenin;#39s hospital of Sernnan, 1999. Materials and Methods. At the first, all infants (n = 77) who re ffer ed to Amiralmomenines hospital with chief complaint icter from May 98 to October 99 were carefully examined and the progress of icter level on the skin was determined. The n, the serum level of bilirubin of the infants was measured by standard laboratory pro cedures. Results. The data indicated tha t as much as the anatomic level of icter p rog ress es, the serum level of bilirubin increases, too. Anatomic level of icter was along th e umblicus or lower in all patients with serum level bilirubins 17 mg/dl or more. In th is level, valu es of se nsitivity, specificity, positive pr edictive a nd negative predi ctive were 100%, 18.6%, 49.2% and 100%, respectively. Infants with an atomic lev el of icter alon g kn ee or lower are at the risk of kernicterus. !n this level, values of sensitivity, sp ecificity, po sitive predictive and negative predictive wer e 100%, 63.9%, 42.1 % an d 100%, respec tively. Conclusion. The above results show that infants with icter level around um blicus need more attention and if the icter level is around th e knees , th e infant will be at the risk of kernicterus .