Hiperbilirubinemia pada neonatus >35 minggu di Indonesia; pemeriksaan dan tatalaksana terkini

Rinawati Rohsiswatmo, Radhian Amandito

Sari


Pada bayi baru lahir terjadi kenaikan fisiologis kadar bilirubin dan 60% bayi >35 minggu akan terlihat ikterik. Namun, 3%-5% dari kejadian ikterik tersebut tidaklah fisiologis dan berisiko untuk terjadinya kerusakan neurologis bahkan kematian. Sebagai pencegahan hiperbilirubinemia berat yang dapat menyebabkan kerusakan neurologis, pemeriksaan bilirubin telah menjadi rekomendasi universal bayi baru lahir yang terlihat kuning. Semakin tinggi perhatian klinisi untuk pencegahan kernikterus, semakin rendah insidensinya. Indonesia menghadapi masalah overtreatment di perkotaan, dan undertreatment di daerah terpencil. Masalah overtreatment ini dapat menyebabkan kecemasan ibu, waktu menyusui anak ke ibu berkurang, serta tidak memungkiri peningkatan biaya yang harus ditanggung. American Academy of Pediatrics (AAP) telah menyusun algoritma dan kurva untuk menyesuaikan tata laksana bayi baru lahir dengan hiperbilirubinemia. Kurva ini mengarahkan klinisi untuk melakukan pengukuran kadar bilirubin dengan cara yang memungkinkan untuk masing-masing fasilitas kesehatan. Pada kenyataannya, masih ada fasilitas kesehatan yang belum memiliki sarana yang memadai untuk pemeriksaan kadar bilirubin maupun terapi sinar. Saat ini ditemukan beberapa penemuan baru, seperti Bilistick, sebagai alat pemeriksaan bilirubin yang kurang invasif dan penggunaan filter atau film untuk menangani hiperbilirubinemia ringan dengan sinar matahari. Penemuan baru inilah yang diharapkan dapat membantu negara berkembang, seperti Indonesia dan lainnya, dalam tata laksana hiperbilirubinemia pada bayi baru lahir.

Kata Kunci


hiperbilirubinemia; neonatus; bilistick

Teks Lengkap:

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Referensi


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DOI: http://dx.doi.org/10.14238/sp20.2.2018.115-22

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