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Article
June 1, 1994

Neonatology

Author Affiliations

University of Washington School of Medicine, Seattle

JAMA. 1994;271(21):1682-1684. doi:10.1001/jama.1994.03510450054030
Abstract

New recommendations for the management of the jaundiced newborn have raised many eyebrows. Much controversy surrounds the long-held exchange transfusion treatment threshold of 342 μmol/L (20 mg/dL) of serum bilirubin in term infants and a somewhat lower, unspecified threshold in preterm infants. Concerns focus on unnecessary laboratory and treatment expenses, including prolonged hospitalization. With earlier hospital discharge of infants, the opportunity to detect and treat jaundice is markedly decreased. Newman and Maisels1 have challenged the standard recommendations for evaluating and treating jaundice in term infants, stating that repeated laboratory tests, the use of phototherapy, and exchange transfusions are in large part unnecessary. They offer two approaches to minimize both risk and cost. The first approach recommends blood grouping and typing of the mother, cord blood grouping and typing of the infant only if the mother is Rh negative or group O, and Coombs' testing of cord blood if there

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