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Early prediction of serious hyperbilirubinaemia

























                         Figure 4.1  Pooled sensitivity of serum bilirubin levels in the first 24 hours of life in predicting later
                         hyperbilirubinaemia
























                         Figure 4.2  Pooled specificity of serum bilirubin levels in the first 24 hours of life in predicting later
                         hyperbilirubinaemia


                         Serum bilirubin levels should be measured  every 6 hours in babies with visible or suspected
                         jaundice whether in treatment or not (see also GDG translation for  Section 7.1.1). These
                         measurements should continue until the serum bilirubin level is stable and/or falling and is also
                         below the treatment thresholds in table 1 and treatment threshold graphs (1.5)
                         Recommendations

                         See the end of Section 4.1.
                         Effectiveness of transcutaneous bilirubin measurement

                         Description of included studies

                                                                                             43
                         Four  studies 43-46   have  been  included  in  this  section.  One  retrospective  study   from  the  USA
                         compared the number of blood samples for bilirubin measurement, treatment with
                         phototherapy, length of hospital stay and readmission rates before and after implementation of
                         transcutaneous bilirubin measurement. The  other three studies 44-46   evaluated the impact of
                         transcutaneous bilirubin measurement on the need for blood sampling. These three studies are
                         described in detail in Chapter 5 on recognition of jaundice.

                         Review findings
                                                                    43
                         A retrospective cohort  study from  the USA   evaluated the impact of pre-discharge
                         transcutaneous bilirubin measurement on laboratory bilirubin testing and readmission rate for
                         hyperbilirubinaemia within  7 days of initial discharge. All healthy babies born in a tertiary


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