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Effectiveness of transcutaneous bilirubin measurement in managing neonatal jaundice in postnatal ward of a tertiary care hospital in Pakistan
  1. Ali Shabbir Hussain1,
  2. Muhammad Hussain Shah1,
  3. Maryam Lakhdir3,
  4. Shabina Ariff1,
  5. Simon Demas1,
  6. Fatima Qaiser2,
  7. Syed Rehan Ali1
  1. 1 Department of Pediatrics, The Aga Khan University Hospital, Karachi, Sindh, Pakistan
  2. 2 Dow University of health sciences, Karachi, Pakistan
  3. 3 Department of Community health sciences, he Aga Khan University Hospital, Karachi, Pakistan
  1. Correspondence to Dr Ali Shabbir Hussain; ali.hussain{at}


Introduction Neonatal jaundice is a common cause of concern in immediate newborn period for parents as well as for the caregivers. Babies with visible jaundice are identified by the healthcare provider, and blood samples are sent for confirmation. Clinical expertise varies from person to person and may lead to sending excessive blood sampling. Obtaining blood bilirubin samples is a painful procedure; it predisposes the baby to infections and requires skilled health personnel. Moreover, laboratory tests are costly and time consuming, leading to unnecessary delays in commencing phototherapy and discharge from hospital. Transcutaneous bilirubinometer has been in use for a long time as screening tool in postnatal wards. With passage of time, its accuracy and validity have improved tremendously.

Methodology We aim to implement a quality improvement initiative to reduce the number of blood bilirubin samples using transcutaneous bilirubin (TcBR) nomogram in full-term, low-risk babies who are born at our hospital and are admitted in postnatal ward after birth. Using preanalysis and postanalysis study design, this study will be performed in two phases of 6 months each. Data regarding total number of admissions in postnatal wards, demographics, serum bilirubin(TSBR) samplings and need for phototherapy will be recorded in both phases. TcBR will be done and recorded in postimplementation phase.

Analysis and results Comparisons between the two groups will be made. Primary outcome will be reduction in blood bilirubin samples for TSBR after the implementation of TcBr protocol. The proportion of infants having TSBR performed in both periods will be compared. Crude sampling cost of TSBR will be obtained from laboratory, and cost comparison between two phases will be done to look for difference.

  • hyperbilirubinemia
  • neonate
  • transcutaneous bilirubin meter

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  • Contributors All authors have contributed equally.

  • Competing interests None declared.

  • Ethics approval Ethical review committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement None.

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