Transcutaneous bilirubin icterometer measurements

Results vary, depending on device used. Can be helpful to assess trends and to determine if blood testing is indicated.

2. Total serum bilirubin. The gold standard to determine degree of jaundice. Total and direct bilirubin levels help to distinguish indirect from direct hyperbilirubinemia. It is essential to interpret bilirubin in terms of postnatal age in hours, particularly in the first several days of life.

3. Direct Coombs test, blood type, and Rh type. Recommended for any infant whose mother is Rh-negative or of unknown blood type. Consider direct Coombs testing in jaundiced new-borns born to mothers with O-type blood. A negative direct Coombs test result does not rule out ABO incompatibility which is often associated with a positive indirect Coombs test, as a cause of jaundice.

4. CBC with smear. Helpful in determining if anemia and evidence of hemolysis are present.

5. Reticulocyte count. May be helpful in determining if hemolysis is present, although results may differ from laboratory to laboratory. In the absence of significant anemia, reticulocyte count is of limited value.

6. Liver function tests. Should be performed in infants and children with systemic infection and sepsis to rule out hepatitis.

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