Implementation and validating transcutaneous bilirubinometry for neonates

Abstract During the first week of life all newborns have increased bilirubin levels by adult standards, with approximately 60% of term babies and 85% of preterm having visible jaundice. A significant reduction in serum bilirubin analysis which is traumatic and painful, could be achieved after implementation of transcutaneous bilirubin (TCB) measurements in preterm babies. Measurements made on the forehead and sternum have the best correlation with TSB. Objectives Is to evaluate the use of non-invasive transcutaneous spectrophotometer, its efficiency and the influence of the site of measurement of transcutaneous bilirubin (forehead and sternum) on the accuracy of bilirubin levels. Subjects and methods This study was conducted on 316 clinically jaundiced neonates in NICU and post-natal clinics of Ain-Shams University Hospital, El Monira Governmental Public Hospital and El Amreky Private Hospital. Neonates of both sexes and gestational age ⩾30 weeks were included, with no hemolytic disease, no known skin disorders or receiving phototherapy or exchange transfusions. Transcutaneous bilirubin using Minolta JM-103 probe from sternum and forehead was measured and compared to serum bilirubin levels. Results There was statistically significant correlation between TSB and TCB in all the groups of studied cases, but was slightly higher in the cases with bilirubin measured in postnatal age of ⩽3 days. In preterm newborns, measurement of TCB from forehead was less accurate than from sternum. Conclusion Noninvasive TCB measurement by Minolta JM-103 has demonstrated significant accuracy compared to TSB measured by clinical laboratory methods in all cases with better accuracy in cases of IHB. TCB measurement over sternum is more accurate than forehead.