Nuclear jaundice occurs in every third newborn baby. This abnormal icteric condition of the skin occurs due to excessive secretion of a substance such as bilirubin.
Under normal conditions, hemoglobin breaks down and bilirubin production occurs in the body of newborns, but a malfunction may occur in which the liver cannot process all the bilirubin formed. The harmful substance enters the bloodstream, acting poorly on the cells of the body and the nervous system. Bilirubin has a nuclear effect, which is why the disease got its name.
Pathogenesis and etiology of the disease
The degree of exposure of bilirubin to the brain and nervous system can be determined by the concentration of the substance in the blood. At a critical mark of 425 μmol, a disease occurs called nuclear jaundice in newborns. This applies only to full-term children. If the birth occurred prematurely, then the indicative mark is reduced. In this case, intrauterine hypoxia of the fetus and various infections affect the decrease in elevation.
In addition, the incompatibility of the blood of the infant and mother is a provoking factor in the development of nuclear jaundice. There is a conflict of Rh blood factors.
Why bilirubin accumulates in the children's body
Bilirubin is a substance that appears as a result of the processing of hemoglobin in the children's body. There are two forms of the substance: soluble and insoluble. Forms of bilirubin have a certain ratio in the body, which is considered the norm, it is 1 to 3. The liver processes the insoluble form of the substance into a soluble one, which is removed from the body naturally with urine and feces.
In newborns, the liver is weak, which means that processing slows down. As a result, the pigment gradually accumulates, not having time to process, nuclear jaundice occurs. The consequences of this disease are serious.
The full-term and prematurity of children also affects the critical level of bilirubin in the blood. The difference is up to 100 μmol. This difference is due to the physical condition of the newborn - in premature babies with a small body weight at birth, internal organs are not fully developed, therefore, the process of processing bilirubin is slowed down. In 80% of cases of preterm birth, there is nuclear jaundice.
Symptoms of the disease
The disease develops within one week. If hemolytic jaundice has already developed in the baby, then outwardly the disease manifests itself after a day.
If nuclear jaundice develops in newborns, the symptoms that issue it may be as follows:
- A sharp deterioration in the general condition of the baby.
- The child has convulsive conditions or apnea.
- External examination indicates the presence of muscle hypertonicity.
- A distinctive feature of nuclear jaundice is the sudden tipping of the head back.
- With a further undetected course of the disease, mental underdevelopment is observed.
- The clinical symptoms of nuclear jaundice may indicate damage to the brain of the newborn.
The occurrence of nuclear jaundice: causes
The main causes of the development of the disease include:
- The conflict between the Rhesus factors of the blood of the baby and mother, that is, the blood group does not combine.
- Lack of a vitamin such as K in the body of the newborn, as well as the effect on the fetus of certain drugs used by the mother during pregnancy.
- Birth hematomas in the baby.
- Lack of oxygen for the fetus or improper metabolism.
- Genetic predisposition.
- Underdevelopment of internal organs.
With excessive production of bilirubin in babies, an icteric color of the skin is observed. Symptoms of nuclear jaundice are almost the same for everyone. It is enough to examine the child according to the Cramer rule: with jaundice, the palms, feet and stomach of the newborn have an abnormal yellow color.
The consequences of nuclear jaundice
The consequences of the disease can be different, it is all about the time of cure and the time of development of nuclear jaundice. The development of encephalopathy may be observed, and in advanced cases, partial deafness and blindness. In addition, in the absence of timely treatment, the risk of brain damage increases, which is the most serious consequence of nuclear jaundice.
With brain damage, children are inhibited, weak, do not respond to stimuli and even the voice of their parents.
If the first signs of jaundice are identified, it is necessary to seek the help of a specialist who will help confirm or refute the diagnosis.
Qualified assistance
Several years ago, glucose and other ineffective drugs were used to treat nuclear jaundice. In modern medicine, the method of phototherapy is most often used - the effect on the newborn's body of certain radiation coming from a special lamp. Thanks to radiation, bilirubin becomes less toxic and is removed from the body naturally, that is, with urine and feces.
In order to avoid the terrible consequences of nuclear jaundice, after the birth of the baby, blood is taken for analysis. Studies are conducted to identify the amount of bilirubin in the baby’s blood. With an excessive amount of substance, special drugs are prescribed that accelerate the process of eliminating toxic pigment. If the child is in a high-risk group, then an internal simultaneous plasma injection is performed.
If nuclear jaundice intensifies, then a plasma infusion is performed in conjunction with phototherapy. In the absence of improvements, it is necessary to resort to a complete blood transfusion.
In the presence of nuclear jaundice, the child is under the supervision of a neurologist. It is this specialist who provides rehabilitation therapy to help restore impaired functions.