What level of bilirubin corresponds to the third zone of jaundice on the Kramer scale?

Table 4: Mean serum bilirubin levels at 24 and 48 hours in different kramer zones. Table 4 shows that at 24 hours, Kramer zone 1 had mean TSB 5.6+1.0, zone II 7.5+1.2 and zone III had 9.7+1.8.

What is Kramer’s scale?

The progression of yellow discolouration of the skin from the head to the feet or cephalocaudal progression was done by using Kramer’s scale. The scale consists of 5 specific ‘dermal zones’ 1) head and neck, 2) upper trunk, 3) lower trunk and thighs, 4)arms & lower legs , 5) palms & soles.

What is the acceptable bilirubin level for newborn?

In a newborn, higher bilirubin is normal due to the stress of birth. Normal indirect bilirubin would be under 5.2 mg/dL within the first 24 hours of birth. But many newborns have some kind of jaundice and bilirubin levels that rise above 5 mg/dL within the first few days after birth.

Which precaution is used during phototherapy?

Expose as much of the skin surface as possible to the phototherapy light. To maximise skin exposure, dress the baby in a nappy and their protective eye covers only.

What is transcutaneous Bilirubinometer?

Transcutaneous bilirubin (TcB) measurement is a non‐invasive method for measuring serum bilirubin level (Dai 1997). Transcutaneous bilirubinometry works by directing light into the skin and measuring the intensity of the wavelength of light that is returned (Boo 2007).

What should a 4 day old bilirubin be?

Physiological jaundice in healthy term babies usually sees bilirubin levels of about 5-6mg/dL on day 4 after birth; they drop over the next week until they reach normal levels. Newborns with multiple risk factors might also develop an exaggerated form of physiological jaundice, with bilirubin levels as high as 17mg/dL.

How is the Kramers rule used to diagnose jaundice?

Kramers Rule Is a quick non invasive method of assessing the degree of jaundice Blanch the skin in each of the five zones shown above, observe the colour of the blanched skin (will be yellow if jaundiced) – it gives you an indication of what the bilirubin level may be The zones show the natural progression of increasing jaundice levels

What was the objective of the bilirubin study?

The objective of the present study was to correlate seric values of bilirubin with the Kramer’s index in a group of newborns with neonatal jaundice, from three different ethnic groups.

What causes bilirubin in a new born baby?

Formation of bilirubin starts from degradation of hemoglobin and haemoprotein, which is released from red blood cell. Current technique in evaluating jaundice of new born infant is based on Kramer’s Rule but unfortunately it is not very applicable to the babies with dark skin.

What is the prevalence of jaundice in newborns?

Hence results revealed that 60 (75%) babies had serum Bilirubin <4 mg/dl, 8 (10%) babies had serum bilirubin in the range of 4-8 mg/dl, 7 (8.75) babies were in the range of 5-12 mg/dl and 5 (6.25%) babies were in the range of 8-16 mg/dl. Out of 80 Newborns, 20 Newborns had Neonatal Jaundice, total incidence rate was 25%.