Abstract
It is quite essential to estimate serum bilirubin in neonates with jaundice. The early prediction of jaundice is usually by observing the yellowish colour of the skin. Various methods of estimation of bilirubin have been developed and used for assessing the risk of jaundice.
 Jaundice is the common neonatal problem, that with the timely diagnosis, effective treatment and proper counselling to the mother can decrease the neonatal morbidity. Proper neonatal examination, breastfeeding advice to the mother, identifying the high risk groups, proper history elicitation, quick diagnosis and early intervention can reduce the incidence of jaundice and also prevent long term complications. The main goal is to prevent the risk of severe hyperbilirubinemia and for prevention of kernicterus. Hence there is a need for a sensitive, rapid and a reliable method for the assessment of serum bilirubin. These methods include both invasive and non-invasive analysis. Invasive methods involve estimation of serum bilirubin by obtaining a plasma or serum sample and non-invasive include the assessment of bilirubin using various instruments without the requirement of blood sample from the neonate.
 As the invasive method of bilirubin estimation needs more time for analysis to yield a result, many non invasive methods are being studied to find an effective tool which can give fast and accurate results ,thus making it an effective screening tool. This review article throws light on the different methods of estimating bilirubin levels in a neonate.
Highlights
Jaundice is one of the common causes for neonatal ICU admission [1]
Our body has natural mechanisms to protect against bilirubin toxicity, these mechanisms include binding of serum bilirubin to serum albumin, and rapid bilirubin uptake, conjugation of the unconjugated bilirubin, and hepatic clearance of bilirubin
All these innate protective mechanisms helps in preventing toxic effects of hyperbilirubinemia, these effects occur mostly in neonates with a high percentage of unconjugated bilirubin and babies with genetic disorders that affect bilirubin conjugation
Summary
Jaundice is mainly a normal condition that happens due to raised levels of bilirubin in the blood, which can cause serious damage to the brain resulting in a poor neurological sequelae and death. Our body has natural mechanisms to protect against bilirubin toxicity, these mechanisms include binding of serum bilirubin to serum albumin, and rapid bilirubin uptake, conjugation of the unconjugated bilirubin, and hepatic clearance of bilirubin. All these innate protective mechanisms helps in preventing toxic effects of hyperbilirubinemia, these effects occur mostly in neonates with a high percentage of unconjugated bilirubin and babies with genetic disorders that affect bilirubin conjugation. Serum bilirubin more than 2 to 2.5mg/dl usually manifests as yellowish discoloration of skin and sclera whereas it is termed latent jaundice when serum bilirubin ranges from 1 to 2 mg/dl [7]
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