Predict, Prevent and Manage Severe Hyperbilirubinemia in Term and Late Preterm Newborns

Disease condition:

  Neonatal hyperbilirubinemia in late preterm ≥35 weeks and term neonates.

Guideline category:

·       Prediction.

·       Prevention.

·       Management.

Clinical specialty:

·       Pediatricians.

·       Neonatologist.

·       Obstetricians.

·       Family physicians.

Intended users:

This evidence base CPG is intended to guide those involved in the management of neonatal hyperbilirubinemia either in primary or secondary/tertiary care namely:

·       Medical officers and general practitioners.

·       Family medicine specialists.

·       Pediatricians, neonatologists and specialists from related disciplines (Nurses and rural health workers).

·       Obstetricians.

·       Parents and care-givers.

GUIDELINES OBJECTIVES

The objectives of this Clinical Practice Guideline is to provide evidence-based guidance on the prediction, prevention and management of severe neonatal hyperbilirubinemia (SNH) specifically adjusted to the customs of the Egyptian community and to integrate it with the already existing health care system to prevent the occurrence of acute bilirubin encephalopathy and kernicterus through the following:

•        Detection of high-risk groups and prediction of severe hyperbilirubinemia.

•        Targeted follow-up of risk groups.

•        Early diagnosis and timely intervention for severe hyperbilirubinemia.

Target Population:

Inclusion and exclusion criteria:

Inclusion criteria:

Newborns with diagnosis of indirect hyperbilirubinemia or at risk for development of severe hyperbilirubinemia meeting the following criteria:

·       Age ≤ 28 days.

·       GA ≥35 weeks.

Exclusion criteria:

·       Neonate with cholestasis.

·       Age >28 days.

·       GA <35 weeks GA.

Healthcare Settings:

•        Community settings: maternal child health care center (MCHC).

Hospitals (maternity and children hospitals whether University, Governmental of Private): Outpatient, inpatient, neonatal intensive care units (NICUs) settings.