A comparison of conventional phototherapy and fiberoptic phototherapy in management of neonatal jaundice

Author: 
Shiv Narayan Panda

Background: Phototherapy is the mainstay in the treatment of neonatal hyperbilirubinemia. Conventional and fiberopticphototherapy are the two different modalities. There are insufficient studies to demonstrate the superiority of one modality over the other modality of phototherapy. So this study was conducted to compare the efficacy of Conventional phototherapy vs. fiberopticphototherapy in the management of unconjugated hyperbilirubinemia in healthy term and late preterm neonates in the first week of life.
Material and Methods: This is a Randomised prospective study. Healthy term and late preterm babies (≥35 weeks) having neonatal jaundice requiring phototherapy as per American Academy of Pediatrics guidelines were randomised to receive Conventional or Fiberoptic phototherapy after satisfying the exclusion criteria. Bilirubin was measured every 12 hourly until phototherapy was discontinued. Primary outcome measure was rate of fall of bilirubin. Secondary outcome measures were duration of phototherapy, failure of phototherapy, need for exchange transfusion and adverse events.
Results: 60 neonates were randomised to either Conventional (n=32) and fiberoptic (n=28) phototherapy group. The base line neonatal and maternal characteristics were comparable between the two groups. Significant difference in the rate of fall of bilirubin [0.17 ± 0.03 mg/dl/hr vs 0.14 ± 0.03 mg/dl/hr; p = 0.0005] was noted. The duration of phototherapy between two groups [27.37 ± 7.6 hrvs 31.29 ± 6.8 hr; p = 0.041] found to be significantly different. There were no failure in phototherapy, no babies required exchange transfusion in both the groups.
Conclusion: Both Conventional phototherapy and Fiberoptic phototherapy are safe and efficacious in management of non hemolytic hyperbilirubinemia in the first week of life in healthy near term and term neonates. Conventional phototherapy is found to be superior to fiberoptic phototherapy so far as the duration of phototherapy and rate of fall of bilirubin during management of neonatal jaundice is concerned.

Page: 
4502-4504
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DOI: 
http://dx.doi.org/10.24327/23956429.ijcmpr201908730
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