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Neonatal jaundice — DRCOG MCQ

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HardNeonatal CareNeonatal jaundiceDRCOG

A 37-week newborn is visibly jaundiced at 36 hours. A transcutaneous bilirubin is 270 micromol/L, above the relevant treatment threshold. The baby is sleepy but rousable and observations are stable. What should happen next?

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

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Correct answer: B — Measure serum bilirubin now and base phototherapy decisions on the serum result

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

A is correct. NICE permits transcutaneous screening after 24 hours in babies born at 35 weeks or later, but a value above 250 micromol/L or at a treatment threshold requires serum bilirubin confirmation; treatment decisions then use the serum value. B delays confirmation of a result already requiring blood sampling. C treats from a measurement that must first be confirmed. D delays a threshold-level result in a sleepy newborn. E substitutes a cholestasis investigation for the immediate unconjugated-hyperbilirubinaemia assessment. Feeding, hydration and neurological state should be assessed while serum testing and treatment preparation proceed.

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