Estimation of various fractions of bilirubin in cases of neonatal jaundice

Abstract

Background & Objectives: Neonatal jaundice causes yellow discoloration of the skin and sclera of the infants, caused by the accumulation of bilirubin in the skin and the mucous membrane. Before discharge the newborn should be examined, monitored and risk due to high bilirubin which maybe genetic be identified to prevent brain damage. Neonatal bilirubin was measured using micro slide technology, whereas Diazo method by Wet chemistry was utilized on the Erba analyzer. Methods: Neonatal bilirubin (N-Bil) was measured using micro slide technology on Vitros 250 (Ortho Clinical Diagnostics USA) Dry Chemistry analyzer. Wet technology was measured using wet technology based on diazo principle by a kit performed on Erba analyzer. Results: Direct Bilirubin showed significantly higher values than conjugated bilirubin (Bc) values and shows poor correlation. Cross reaction may occur between Direct bilirubin and Bc which is clinically misleading. Conclusion: Neonatal bilirubin (N-Bil) is better parameter than total bilirubin (T Bil) in assessing neonatal jaundice in newborns. The slide provides bichromatic accurate readings of unconjugated bilirubin (Bu) at 460nm and conjugated bilirubin (Bc) 420 nm without photometric interference from hemoglobin and albumin. Diazo method is the most widely used method for bilirubin estimation till date. The Kodak Ektachem (Eastman Kodak company Rochester NY 14650) dry –slide method directly estimates unconjugated(Bu) and conjugated bilirubin (Bc) by a rapid automated method developed in the 1980’s.Bc concentrations are a marker of variety of infections, metabolic or liver conditions. Keywords: Neonatal bilirubin, Unconjugated bilirubin, Conjugated bilirubin, Total bilirubin, Direct bilirubin, Jaundice