Page 294 - Abstract Book KONIKA 18

Neonatology

P-NEO-015
Acute Phase of Neonatal Kernicterus: A Case Report

Grace Erdiana
Duta Indah Hospital, North Jakarta, Indonesia

Abstract
Background Kernicterus, also known as bilirubin encephalopathy is a condition of high levels bilirubin serum
(>20 mg/dL) cause necrosis of the nerves and neurological damage. This incident occurs more frequently in
underdeveloped countries. Clinical manifestation of kernicterus can be acute (early, intermediate, advance)
and chronic phase. Early treatment such as transfusion exchange, phototherapy, and albumin therapy
should be done to prevent the progression, but long term management shouldn’t be forgotten to focus on
possibilities sequelae of neurological disorders that require physical, speech, auditory, and other complications.
Objective To describe the importance of doing screening for prevent high bilirubin serum that can lead
to bilirubin encephalopathy and impact on child development. Case A 6 days old boy neonate presented
with icterus from head to lower extremity, accompanied by stiffness, opisthotonus and fever. He was born
from multigravida mother by caesarean delivery, in good condition with apgar score 7/9 and birth weight
2775 g, then discharge 2 days after. While at home, his breastfeeding didn’t adequate. Total bilirubin serum was
40.46 mg/dL, he received double phototherapy and phenobarbital injection. After 5 days of treatment,
the icterus slightly reduced, his body no longer opisthotonus, and total bilirubin serum was 10.9 mg/dL.
Patient was referred to another hospital for neurological screening. Conclusion This case report shows the
consequence of kernicterus in neonate, adequate phototherapy treatment for reduce bilirubin serum, and
neurological screening after to prevent life long effects.
Keywords: Kernicterus; bilirubin encephalopathy; phototherapy

P-NEO-016
Correlation between Noise Level of Delivery Rooms
with the Success of Early Initiation of Breastfeeding

Nurul Hudayani, Ema Alasiry, A. Dwi Bahagia Febriani
Department of Child Health, Faculty of Medicine Universitas Hasanuddin, Makassar, South Sulawesi, Indonesia

Abstract
Background Early Initiation of Breastfeeding (EIB) is the process of allowing a baby on his own instinct to
breastfeed within the first hour after birth, along with skin contact between the mother's skin and the baby's
skin. Objective To determine the relationship between the noise level of the delivery room and the success
of EIB. Methods This study used a prospective cohort design which was conducted at Rumah Sakit Umum
Pusat (RSUP) Dr. Wahidin Sudirohusodo Makassar. The population was babies born by vaginal birth, healthy,
gestational age > 35 weeks from healthy and stable mothers. Results This study compared the frequency of
success of EIB on the subject in environments with noise levels <50 decibels (dB) and ≥ 50 dB. This study
involved 49 healthy newborns from vaginal birth. Most (93.3%) infants had birth weight ≥ 2,500 grams and
34.7% were the first pregnancies. There was no significant relationship between subjects and the noise level
group <50 dB and ≥ 50 dB based on gender, birth weight, parity, and mother’s level of education (P > 0.05).
A total of 23 82.6% (19/23 samples) of subjects in the noise level group <50 dB showed successful EIB
and 92.3% (24/26 samples) of subjects in the noise level group ≥ 50 dB showed the failure of EIB. There
was a statistically significant relationship between the noise level and the success of EIB (P <0.05; OR = 57
[95%CI 9.41 to 345.15]). Conclusion The risk of EIB failure in infants exposed to noise levels more than
50 dB was 57-fold greater than those exposed to noise levels less than 50 dB.
Keywords: early initiation of breastfeeding; noise

246 KONIKA XVIII Abstract Book