hemolytic disease of the newborn(redirected from Hemolytic disease)
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hemolytic disease of the newbornAlloimmune anemia of newborns,
erythroblastosis fetalis Neonatology, pediatric hematology Hemolysis due to incompatibility of fetal antigens with maternal immune system, caused by production of maternal IgG antibodies in response to fetal RBCs that enter the maternal circulation; if the IgG response and sharing of circulations–as occurs in low-grade fetomaternal hemorrhage, is intense, erythoblastosis fetalis occurs Clinical See Hydrops fetalis Lab If hemolysis is intense, the excess unconjugated/indirect BR overloads infant's liver; because of blood-brain barrier immaturity, BR deposits in basal ganglia of the brain, causing cell death, and kernicterus. See Alloimmune anemia of newborn, Kell blood group, Kernicterus. Cf Hemorrhagic disease of the newborn.
hemolytic disease of the newborn
This disease is caused by transplacental transmission of maternal antibody, usually evoked by maternal and fetal blood group incompatibility. Incompatibilities of the ABO system are common but are not severe because maternal antibodies are too large to cross the placenta readily. Rh incompatibility, however, can result in profound fetal anemia, causing death in utero.
Rh incompatibility may develop when an Rh-negative woman carries an Rh-positive fetus. At the time of delivery, fetal red blood cells may enter maternal circulation, stimulating antibody production against the Rh factor. In a subsequent pregnancy, these antibodies cross the placenta to the fetal circulation and destroy fetal red blood cells.
In cases of Rh incompatibility, the condition can be controlled during pregnancy by following the anti-Rh titer of the mother's blood and the bilirubin level of the fetus by amniocentesis. These indices show whether the pregnancy should be allowed to go to full term and if intrauterine transfusion is indicated; or if labor should be induced earlier. Delivery should be as free of trauma as possible and the placenta should not be manually removed. The infant with hemolytic disease should be immediately seen by a physician who is capable of and has the facilities and blood supplies available for exchange transfusion. The use of Rh (D) immune globulin after abortion, at 28 weeks' gestation, and within 72 hr of delivery has been beneficial.