Neonatal Jaundice

Unconjugated hyperbilirubinaemia

Increase in bilirubin

1. Polycythaemia – intra-uterine growth retardation, delay cord clamping, twin-twin transfusion syndrome
2. Haemolysis – Rhesus, ABO incompatibility, G6PD, phenylketonuria, spheroeliptocytosis, infection
3. Sequestered – cephalhaematoma, bruising, intraventricular haemorrhage
4. Increased enterohepatic circulation – fasting, delay stooling, swallowed blood, gastrointestinal obstruction
5. Drugs – synthetic vitamin K3, oxytocin, naphthalene

Decrease uptake, conjugation, and excretion

1. inherited conjugated defects –
   1. Crigler-Najjar Syndrome types I & II
   2. Lucey-Driscoll syndrome
   3. Gilbert’s syndrome
2. breast milk
3. hypothyroidism

Increase enterohepatic circulation

1. intestinal obstruction / delay – e.g. meconium / paralytic ileus

Conjugated hyperbilirubinaemia

Hepatocellular disease

• infections – neonatal sepsis, TORCH
• metabolic – cystic fibrosis, galactosaemia, α-1 antitrypsin deficiency
• prolonged parenteral nutrition

Biliary atresia

• intrahepatic
• extrahepatic

Obstructions

• inspissated bile syndrome
• choledochal cyst