In hemolytic disease of the newborn often a pregnant woman carries a foetus with a different blood type to herself, and sometimes the mother forms antibodies against the red blood cells of the foetus, leading to low foetal blood counts to, a condition known as hemolytic disease of the newborn or hemolytic disease of the fetus . (Hemolytic disease of the newborn also known as HDN or HDFN or erythroblastosis foeatlis) is an alloimmune condition that develops in a foetus when the IgG antibodies produced by the mother and passing through the placenta include ones which attack the red blood cells in the foetal circulation. The red cells are broken down and the foetus can develop reticulocytosis and anaemia .
- The foetal disease ranges from mild to vary severe and foetal death from heart failure hydrops fetalis can occur .
- When the hemolytic disease of the newborn is moderate or severe many erythroblasts are present in the foetal blood and so these forms of the disease can be called erythroblastosis foetalis .
Hemolytic disease of the newborn treatment
Before birth, options for treatment include intrauterine transfusion or early induction of labor when pulmonary maturity has been attained, foetal distress is present or 35 to 37 weeks of gestation have passed. The mother may also undergo plasma exchange to reduce the circulating levels of antibodies by as much as 75%. After birth, treatment depends on the severity of the condition, but could include temperature , stabilization and monitoring, phototherapy , transfusion with compatible packed red blood, exchange transfusion with a blood type compatible with both the infant and the mother, sodium bicarbonate for correction of acidosis and / or assisted ventilation. Rh negative mothers who have had a pregnancy with or are pregnant with a Rh positive infant, are given Rh immune globulin (RhIG ) also known as Rhogam , during pregnancy and after delivery to prevent sensitization to the D antigen . It works by binding any fetal red cells with the D antigen before the mother is able to produce an immune response and form anti – D IgG . A drawback to prepartum administration of RhIG is that it causes a positive antibody screen when the mother is tested which is indistinguishable from immune reasons for antibody production.
|Rh hemolytic disease|
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