General Data

• AS
• 9 day old/M
• Roman Catholic
• Consolacion
• Admitted for the 1st time in UCMed
Prenatal History
• Born to a 30 yr G2P1 mother with unremarkable maternal history.
• PNCs done at 4 wks AOG with OB-Gyne at a hospital
History of Present Illness
• Delivered via NSD, term with BW 2.9 kg at another HC institution
• 24 hrs old- Jaundice was noted down to abdomen; TBDB was checked
with TB 21 mg/dl (as claimed by mother). Double Phototherapy was
done
• 2 days old- received one dose of IVIG and continued on double
phototherapy
• 3 days old- repeat TBDB with TB 20 mg/dl
• 4days old- TB of 23; appraised for exchange transfusion- HAMA
• In the interim- progression of jaundice noted down to feet
History of Present Illness
• 1 day PTA, sought consult with AP. TBDB at 8 days old
23.01/1.62/21.39, CRP 0.9, Blood type A+, CBC 128/0.36/11.0/572
32/37/13/6/0 bands 12.0; advised admission. Thus, patient was
referred to a neonatologist and subsequently admitted.
Physical Examination
• General: awake, alert
• Vs: T 36.6, PR 157, RR 40, WT 3.7 kg
• Skin: warm, no lesions, jaundice down to feet
• HEENT: + Icteric sclerae, moist lips and oral mucosa, flat fontanels
• C/L: ECE, CBS, no rales, no wheeze
• CVS: DHS, RRR, no murmur
• Abdomen: soft, nondistended, no organomegaly
• Extremities: warm, SPP, CRT less than 2s
Labs
• TBDB at 8 days old 23.01/1.62/21.39
• CRP 0.9
• Blood type A+
• CBC 128/0.36/11.0/572 32/37/13/6/0 bands 12.0

• IVF: D5IMB @
• Started on double phototherapy
Course in the wards
DAY 1
S O A P
Good suck VS: T 36.6, PR152, RR 40 Hyperbilirubinemia sec to Phototherapy continued
Feeds well ABO incompatibility FOR Repeat TBDB
+ BM X 5 Skin: warm, good turgor,
no lesions, + jaundice
down to upper thighs
HEENT: + slightly icteric
sclerae
C/L: ECE, CBS
CVS: DHS, RRR, No
murmur
Extremities: warm, SPP,
CRT less than 2 s
Course in the wards
DAY 2
S O A P
Good suck VS: T 36.6, PR152, RR 40 Hyperbilirubinemia sec to Phototherapy
Feeds well ABO incompatibility discontinued
+ BM X 2 Skin: warm, good turgor,
no lesions, + jaundice Cleared for discharge
down to upper thighs
HEENT: + slightly icteric
sclerae
C/L: ECE, CBS
CVS: DHS, RRR, No
murmur
Extremities: warm, SPP,
CRT less than 2 s

TBDB: 14.1/0.53/13.58
Thank you