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Early neonatal jaundice — DRCOG MCQ

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HardNeonatalEarly neonatal jaundiceDRCOG

A term baby develops visible jaundice at 18 hours. Serum bilirubin is below the phototherapy line, the direct antiglobulin test is pending and the baby is clinically stable. Which monitoring plan follows NICE guidance?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: E — Obtain urgent medical review and repeat serum bilirubin six-hourly until stable or falling below threshold

Explanation lettering: E = shown as A · D = shown as B · A = shown as C · B = shown as D · C = shown as E

C is correct. Jaundice in the first 24 hours requires urgent medical review, serum measurement within 2 hours and repeat serum bilirubin every 6 hours until the value is below the treatment threshold and stable or falling. D uses the wrong measurement method in the first 24 hours and delays review. E treats a single subthreshold value as excluding evolving haemolysis. A discharges before the mandated early trend is established. B starts treatment without crossing the age-specific threshold and then removes necessary monitoring. Assessment should investigate haemolysis, infection and other early-onset causes in parallel.

Reference: NICE CG98: Jaundice in newborn babies under 28 days—recommendations: https://www.nice.org.uk/guidance/cg98/chapter/recommendations