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Indian Pediatr 2018;55: 80 |
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Transcutaneous Bilirubin Measurement in
Preterm Neonates Receiving Phototherapy:
Author's Reply
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Amruta Pendse1 and
Bonny Jasani2
1Department of Neonatology, KEM Hospital for
Women, Perth WA Australia; and 2Hospital for Sick Children,
Toronto, Ontario, Canada.
Email: 1[email protected]
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We thank the readers for highlighting few important points related to
our study on comparison of transcutaneous bilirubin measurement with
total serum bilirubin levels in preterm neonates receiving phototherapy
[1]. We completely agree that visual inspection of jaundice in preterm
infants is fraught with problems, and may be unreliable. But in
developing countries with plenty of preterm neonates in the NICUs, it
can serve as a valid screening tool and help triage the neonates which
need to be tested for jaundice earlier in comparison to others. We
screened eligible neonates for jaundice and tested them if their visual
assessment as per Kramer’s scale [2] was above the cut-off for that
particular gestation [3]. In addition, we used a stool colour chart [4],
to exclude conjugated jaundice. We did not perform additional
investigations for the purpose of the study, but in circumstances like
Rh-negative mother, we definitely performed the required investigations
as per our unit policy.
References
1. Pendse A, Jasani B, Nanavati R, Kabra NK.
Comparison of transcutaneous bilirubin measurement with total serum
bilirubin levels in preterm neonates receiving phototherapy. Indian
Pediatr. 2017;54:641-3.
2. Kramer LI. Advancement of dermal icterus in
jaundiced newborn. Am J Dis Child. 1969;118:454-8.
3. Maisels MJ, Watchko JF, Bhutani VK, Stevenson DK.
An approach to the management of hyperbilirubinemia in the preterm
infant less than 35 weeks of gestation. J Perinatol. 2012;32:660-4.
4. Chen SM, Chang MH, Du JC, Lin CC, Chen AC, Lee HC, et al.
Screening for biliary atresia by infant stool color card in Taiwan.
Pediatrics. 2006;117:1147-54.
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