AJ Journal of Medical Sciences

Abstract

Background and Objectives: Hyperbilirubinemia or jaundice is a common condition found in neonates. If early intervention is not initiated in case of gradually increasing hyperbilirubinemia it may progress to develop a dreadful condition called kernicterus. Subclinical dehydration resulting from evaporative losses and inadequate breast milk intake may contribute to a higher incidence and increased severity of neonatal jaundice, thereby prolonging the required duration of phototherapy. Supplementation of neonates with additional intravenous fluids to dilute the blood, along with increased feeding to promote bilirubin excretion through bowel movements, has been a common practice. This study evaluated whether fluid supplementation offers any added advantage when combined with phototherapy in the management of severe neonatal hyperbilirubinemia. Methodology: In this interventional study, healthy term neonates (37–41 weeks of gestation) with severe hyperbilirubinemia requiring phototherapy were randomly assigned to two groups using the odd–even number method. A total of 42 term neonates with hyperbilirubinemia were enrolled. The intervention group received intravenous fluids for a total of 24 hours in addition to breastfeeding, while the control group was provided only breastfeeding along with intensive phototherapy. Serum bilirubin levels were assessed at baseline and at 4, 8, 12, 24, 36, and 48 hours after initiating phototherapy, and the rate of decline in serum bilirubin levels was calculated. Results: Baseline variables such as gender, age at the time of hospital visit and getting admitted, weight taken at birth, weight measured at the time of getting admitted to the hospital, mode of delivery, oxytocin use, incidence of breast feeding and serum bilirubin at the time of inclusion in study, were comparable in both groups. Variation in TSB levels at 4^th hour, 8^th hour, 12^th hour and 24^th hour of study were greater in study group. Although the drop in TSB level at 36^th and 48^th hour between two groups and PCV between the groups following intervention was not significant. Conclusion: It can be said that the drop in bilirubin levels and duration of phototherapy in study group was lesser than the control group after receiving additional IVF supplementation.