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Correspondence

Indian Pediatr 2018;55: 80

Transcutaneous Bilirubin Measurement in Preterm Neonates Receiving Phototherapy:
Author's Reply

 

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]

 

 


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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