hemolytic disease of the newborn

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hemolytic disease of the newborn

Alloimmune 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

A neonatal disease characterized by anemia, jaundice, liver and spleen enlargement, and generalized edema (hydrops fetalis). Synonym: erythroblastosis fetalis See: Rh blood group

Etiology

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.

Treatment

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.

Hemolytic disease of the newborn

Also known as erythroblastosis neonatorum, this is a condition in which a newborn's red blood cells are destroyed by antibodies that have crossed the placenta from the mother's blood. (Hemolytic disease begins in the fetus, in whom the disease is called erythroblastosis fetalis). Severe anemia caused by hemolytic disease is treated in the same way as other anemias, but when jaundice appears due to increased bilirubin, the jaundice is treated by exposing the infant to bright lights. In severe cases, exchange transfusion is required or brain damage may result.
Mentioned in: Liver Function Tests
References in periodicals archive ?
Food and Drug Administration (FDA) has granted Fast Track designation for M281, Momenta's IgG1 monoclonal antibody targeting FcRn, in Hemolytic Disease of the Fetus and Newborn (HDFN).
FLEXBUMIN 25% is indicated for hypovolemia, hypoalbuminemia, (burns, Adult Respiratory Distress Syndrome, and nephrosis), cardiopulmonary bypass surgery, and hemolytic disease of the newborn.
Hemolytic disease of the newborn occurs as a result of hemolysis and shortening of the life span of the new-born's erythrocytes because of antibodies crossing from the mother by the placenta (5).
Hemolytic disease of the fetus and newborn (originally termed hemolytic disease of the newborn) was first clinically described by Levine et al.
Background: ABO hemolytic disease is the most frequent cause of neonatal jaundice.
Despite this preventive measure, alloimmunization due to anti-D, anti-c, and anti-Kell are commonly seen as the most common causes of hemolytic disease of the fetus and newborn (HDFN).
Severe hemolytic disease of the newborn in a group B African-American infant delivered by a group O mother.
PCH is an intravascular hemolytic disease in which hemolysis is related to exposure to cold temperatures [1].
The exclusion criteria comprised signs of sepsis, electrolyte impairment, any congenital anomalies or diseases, seizure, formula feeding, hemolytic disease, and need for exchange transfusion.
They also discuss the pathobiology of bilirubin-induced neurotoxicity, the clinical diagnosis and outcome of kernicterus, the contributions of hemolytic disease and glucose-6-phosphate dehydrogenase deficiency to hyperbilirubinemia, and risk assessment and treatment with phototherapy and other modalities.
(1-6) ABO Rh incompatibility results in severe hemolytic disease of newborn in India, Sri Lanka and Bangladesh and it often requires multiple exchange transfusions.

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