The complications caused by severe jaundice in a newborn baby are called kernicterus. This condition occurs when the baby’s blood and brain tissues collect a waste product from the body. Though the symptoms are usually mild and can be controlled if detected earlier, some babies may experience severe complications due to kernicterus.

Here’s more on it!

What is Kernicterus? 

When a newborn baby has hyperbilirubinemia (excessive bilirubin in their blood), their brain gets affected by kernicterus. The body produces bilirubin. It is a waste product that is removed by the liver, but sometimes, the liver fails to remove the required amount of bilirubin, causing jaundice. At this point, the affected individual’s skin, gums, eyes, and areas under their tongue turn yellow. 

Apart from jaundice, newborns also suffer from seizures, irritability, poor feeding, etc. In fact, the complications can cause permanent damage to the hearing ability and the brain. It is essential to contact your healthcare provider immediately if you notice any such symptoms in the baby.

What are the Causes of Kernicterus?

The primary cause of kernicterus is severe jaundice among infants, which is not treated in a timely manner. Excessive bilirubin in the infant’s blood causes jaundice. It is a yellow-orange pigment formed from the breakdown of red blood cells. The liver filters bilirubin and removes it from the baby’s body through the stool.

A baby’s liver may not always function effectively in removing bilirubin, as it is not yet fully developed like an adult’s. Thus, most babies develop jaundice after birth. However, jaundice gets cured within a week or two if diagnosed at the right time and treated properly.

When bilirubin levels increase and spread to the infant’s brain, damaging the central nervous system, kernicterus occurs.

What are the Risk Factors of Kernicterus? 

Here are some of the factors that increase the risk of kernicterus in a newborn baby:

• If a newborn gets affected with Rh haemolytic disease, the risk of severe jaundice increases.
• Premature babies are at higher risk of jaundice, as the liver function is inefficient.
• Haemolytic conditions that lead to haemolysis (breaking down red blood cells).
• If a child has a family history of kernicterus or jaundice.
• When a child does not get adequate breastfeeding, it causes dehydration, which can lead to jaundice.

What are the Symptoms of Kernicterus?

A baby gets kernicterus symptoms within the first few days of birth. In some babies, symptoms appear gradually, and early signs may not always be readily apparent. However, early recognition helps prevent severe damage.

Here are some of the symptoms of kernicterus that you must know:

• Hypotonia (low muscle tone)
• Opisthotonus (neck or back arching)
• The baby may have a poor sucking reflex or face difficulty while feeding
• Distressed or abnormal crying at high-pitched sounds
• The baby may experience extreme tiredness and take time to wake up
• Seizures
• Moro reflex 
• Irritability
• Rigid or stiff muscles
• Yellow eyes and skin that may worsen over time
• Downward gaze or unusual movement of eyes

How to Diagnose Kernicterus? 

Kernicterus is identified using several diagnostic approaches, each targeting specific aspects of the condition. Here are the primary methods:

• Bilirubin Level Test

This blood test determines the amount of bilirubin in the baby’s bloodstream. Elevated levels signal a risk for kernicterus and require immediate attention.

• Transcutaneous Bilirubin Test

A non-invasive device scans the baby’s skin to estimate bilirubin levels. If the reading is high, a confirmatory blood test is usually performed.

• Blood Type and Coombs Test

These tests check for incompatibility between the mother’s and baby’s blood types, which can cause increased bilirubin due to red blood cell breakdown.

• Complete Blood Count (CBC)

This test checks for anaemia or infection, both of which can exacerbate jaundice and increase the risk of kernicterus.

• Reticulocyte Count

By measuring the number of young red blood cells, this test helps determine if the baby’s body is compensating for ongoing red blood cell destruction.

• Brainstem Auditory Evoked Response (BAER)

This hearing test detects early signs of brain damage, as hearing loss is a common complication of kernicterus.

• Electrolyte Panel

This blood test checks for imbalances in sodium, potassium, and other electrolytes, which may indicate dehydration or cell breakdown.

• Neurological Imaging

In rare cases, imaging studies such as ultrasound, MRI, or CT scans are used to investigate unexplained symptoms and assess potential brain injury.

What are the Treatment Options for Kernicterus?

Here are some of the effective treatment methods for kernicterus:

• Phototherapy (Light Therapy)

This treatment uses special medical lights that shine on the baby’s skin. The light helps break down excess bilirubin in the blood, making it easier for the baby’s body to remove it. During the session, the baby lies under the lights with their eyes protected to prevent any harm.

• Exchange Blood Transfusions

In severe cases, a healthcare provider may replace the baby’s blood with donor blood or plasma. This process removes bilirubin quickly, reducing the risk of further brain damage. The procedure involves inserting a tube into a vein or the umbilical stump to gradually exchange blood.

• Intravenous Immunoglobulins (IVIG)

If the baby’s jaundice is caused by Rh incompatibility, IVIG may be given. This treatment involves infusing antibodies through a vein to help stop the breakdown of red blood cells, lowering bilirubin levels and reducing the need for a transfusion.

FAQs About Kernicterus

1. What are the different stages of kernicterus?

Kernicterus progresses from early, treatable symptoms to middle and late stages, where severe issues like fever, coma, and permanent brain or hearing damage become much more likely.

2. What are the complications of kernicterus?

Complications of kernicterus can be severe and lifelong, including hearing loss, cerebral palsy, permanent brain damage, problems with cognitive development, and, in extreme cases, coma or even death.

3. Is kernicterus curable?

Kernicterus cannot be cured, but early treatment can stop further brain damage. Prompt monitoring and intervention for jaundice in newborns is essential to prevent serious, irreversible complications.

Conclusion

Newborn babies often develop conditions like kernicterus due to excessive bilirubin production. This condition can be managed to prevent further complications and brain damage if the symptoms are detected earlier. 

For medical students, a detailed understanding of this condition is essential to fully cover the NEET PG syllabus. With DocTutorials, you can learn topics such as kernicterus and others included in the NEET PG course under the guidance of top faculty members.For more details, join our NEET PG course today!