Management of neonatal hyperbilirubinaemia and prevention of kernicterus.

Hyperbilirubinaemia remains one of the most common and more important pathological conditions in the newborn. The possibility that the so-called physiological or developmental hyperbilirubinaemia, with relatively low levels of serum bilirubin, could be responsible for bilirubin encephalopathy in the small premature infant is of great concern to the neonatologist; premature newborns are prone to developing hyperbilirubinaemia. Current methodologies for suppressing severe neonatal jaundice include: (a) attempts to stimulate liver conjugating enzymes using drugs such as phenobarbital; (b) attempts to degrade bilirubin with phototherapy; and (c) exchange transfusion. It is too soon to consider tin-protoporphyrin as a drug for the prevention and treatment of neonatal hyperbilirubinaemia. However, if it can be shown that tin-protoporphyrin can serve as a safe and less costly alternate treatment, a considerable improvement in the management of neonatal jaundice would be achieved.