A STUDY OF REBOUND HYPERBILIRUBINEMIA IN POST PHOTOTHERAPY NEONATES
Arakhita Swain*, Shantisena Mishra, Ajit Mishra and Dr. Saiprasanna Behera
ABSTRACT
Background: Phototherapy is widely accepted as a relatively safe and effective method for treatment of neonatal Hyperbilirubinaemia. Billirubin level often increases following cessation of phototherapy. This rebound hyperbillirubinemia may be dangerous to the neonate. However, routine measurement of billirubin rebound following phototherapy will definitely increase the workload, add to the expenses, bring anxiety to the parents and prolong the hospital stay. This study was conducted in our institution to throw some light on rebound hyperbilirubinaemia. Aims and Objectives: This study was designed with an aim and objective to, a) find out the incidence of rebound hyperbillirubinemia in neonates following cessation of phototherapy, b) determine the specific etiological factors responsible for the condition, c) determine the necessity of therapy and d) find the specific therapy needed to treat billirubin rebound. Materials and Methods: Newborns with hyperbilirubinaemia and needing Phototherapy were considered for study purpose. Given phototherapy after detailed history, physical examination and relevant investigation. Post-Phototherapy serum bilirubin estimated to see if rebound hyperbilirubinaemia is there and followed up as per the result. Results: In this series of total 126 neonates, 46 (36.5%) had post phototherapy rise of serum bilirubin to some extent which was found to decrease with time when followed up subsequently. Only 14 neonates, which constitutes 11.1% of all jaundiced neonate had developed post phototherapy rise of serum bilirubin to a significant level requiring retreatment. All babies recovered uneventfully. Conclusion: Post-Phototherapy rebound hyperbilirubinaemia is not uncommon. It is benign in course and resolves uneventfully. Regular post phototherapy bilirubin estimation may not be that much essential; but chance of occurrence of rebound hyperbilirubinemia and its subsequent consequences must not be ignored especially in presence of the risk factors.
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