Question
How can we determine whether the jaundice in a newborn with a total bilirubin index of 308.02 is physiological or pathological?
Answer
At 7 days old, the newborn’s total bilirubin index is 308.02. The mother has O-negative blood type, the father has A-positive blood type, and the newborn also has O-negative blood type. Based on this information, hemolytic jaundice caused by incompatibility between maternal and fetal blood types can be ruled out. The significant decrease in bilirubin index indicates the presence of pathological jaundice. Typically, the breakdown of red blood cells after birth leads to an increase in serum bilirubin. If the child’s metabolism of bilirubin is slow and there is excessive reabsorption of bilirubin due to hepatic-intestinal circulation, jaundice can occur. Factors such as infection, skin damage, aspiration, and congenital hypothyroidism should be excluded. Based on the indirect bilirubin decrease, phototherapy is recommended.