การตรวจกรองภาวะตัวเหลืองในทารกแรกเกิดโดยวิธีการวัดระดับบิลิรูบินผ่านทางผิวหนัง

Abstract

Diagnosis of neonatal jaundice requires measuring of serum bilirubin. Transcutaneous bili-rubinometry may be used as a screening test to reduce a number of heel sticks for blood sampling in infants. Objective: To evaluate the accuracy of transcutaneous bilirubinometry in estimating total serum bilirubin (TSB). Methodology: Transcutaneous bilirubin (TcB) indices measured on forehead were performed in term infants by using  JM-102 Minolta Airshields Jaundice Meter. TSB levels were also determined from heel-stick blood samplings. Results: 128 infants were enrolled into the study.  The average gestational age and birth weight were 38.64± 1.13 weeks and 3169.49 ± 372.72 grams respectively. The average age at the time of bilirubin measurements was 70.87± 21.44 hours. The regression equation yielded coefficientof determination (r 2) of 0.60. When TSB of 11 mg/dL was used as the cut of point the sensitivity and specificity of the TcB measurement were 82.76% and 78.57% respectively. Conclusion: TcB measurements were moderately accurate for predicting TSB levels. Transcutaneous  bilirubinometry is probably appropriate for screening mild degree of neonatal hyperbilirubinemia. In infants  with moderate to severe hyperbilirubinemia TSB should be determined.