Question of the Week

Question :
Posted On : 31 Aug 2025
A newborn came on D14, his weight is 2.0 Kg, Full Term, TSB-15.2, DIRECT-2.8, septic screen negative, blood group-B+, Mother blood Grp O+, sgot sgpt around 480, baby is active feeding normally. How should I approach this now? What is the role of Photo therapy at this stage?
5
Expert Answer :
Check the LFT again and see if direct jaundice is rising. If yes, you need to work up for neonatal cholestasis.
Answer Discussion :
H
Hafiz Akhtar
Profile
Babies remain well unless their neurological and hamodynamic status is not compromised so don,t go on the well-being of baby. It is a complex situation needing aggressive approach to reach the accurate diagnosis.
RED FLAGS in this case are 1: Hyperbilirubinaemea with LBW,2:ABO Incompatiblity and hepatic injury (post Cholistatic)
IMMEDIATE ACTION should be 1: Admission in NICU With co-ordinated management by Neonatologist and paediatric Gastroenterologist/Hepatologist.
IMMEDIATE WORKUP FOR,
Infectious, Genetic/Metabolic, Structural(biliary atresia) defects and Idiopathic Neonatal Hepatitis is required. Alpha-1 Antitrypsin deficiency must also be considered.In neonates UTI may also present with cholistates and increased Liver enzymes
IMMEDIATE TREATMENT FOR,
1:Hyperbilirubinaemea (indirect)as baby is 2 kg —phototherapy 2: Hydration & Nutrition and 3: Treatment of cause.

2 Days ago
M
Manar Aref
Profile
prolonged neonatal jaundice, increased DSB goes with cholestasis. what about CBC especially Hb level bec risk of Inspissated bile syndrome is possible, do urine analysis bec some cases with UTI has prolonged jaundice,
is stool colour clay ?? this is important to exclude biliary atresia

5 Days ago
S
Shilpa Rahamatkar
Profile
D14..... TSB 15.2....needs phototherapy.....rule out probable ABO incompatibility ....liver enzymes too raised ....needs more inv ...
5 Days ago
A
Abdo Free
Profile
request coomb,s test firstly to exclude aiha
5 Days ago
I
Iqra Arif
Profile
neonatal hepatitis,
detailed lfts, stool color, usg abdomen

5 Days ago




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