Ictère nucléaire dans un contexte de naissance à domicile

This is the clinical history of a term baby born at home who presents a severe hyperbilirubinémia. The medical monitoring was assessed by a private midwife according to parental choice. On the third day of life, the newborn presented an icterus and was exposed to natural daylight in the familial gre...

Full description

Saved in:
Bibliographic Details
Published inRevue médicale de Bruxelles Vol. 37; no. 1; p. 13
Main Authors Dussart, A, De Buyst, J, Djeunang, C, Janssens, M, Müller, M-F, Strebelle, E, Mathe, K, Infantino, S, Malfilâtre, G
Format Journal Article
LanguageFrench
Published Belgium 01.01.2016
Subjects
Female
Fetal Macrosomia - complications
Fetal Macrosomia - diagnosis
Fetal Macrosomia - therapy
Home Childbirth
Humans
Infant, Newborn
Kernicterus - complications
Kernicterus - diagnosis
Kernicterus - therapy
Phototherapy
Pregnancy
Online AccessGet full text

Cover

More Information
Summary:This is the clinical history of a term baby born at home who presents a severe hyperbilirubinémia. The medical monitoring was assessed by a private midwife according to parental choice. On the third day of life, the newborn presented an icterus and was exposed to natural daylight in the familial greenhouse under the midwife recommandations. On that day, no laboratory test precised the bilirubin level. On the fifth day, a blood sampling revealed a very high blood bilirubinémia (31 mg/dl or 527 mmol/L), the baby is refered to our NICU and underwent an exchange transfusion. The radiological assessment report structural abnomalies in basal ganglia seen on both MRI and transfontannellar echography. These lesions are known to be responsible of cerebral palsy and hearing loos. The neurophysiologic investigations showed background abnormaly and depression. The extensive blood sampling excluded haemolysis. The clinical examination brought out neurologic impairement and weight loos in this exclusively breastfed baby. This clinical case point out the increasing risk of home Kernicterius as hospital stays diminish and homebirth enthousiasm rise up. The present clinical situation vouches for an adaptation of care giving to both mother and child at home in order to avoid this severe illness.
ISSN:0035-3639