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Intro, Disease Process, Classification & Pathogenesis

Hemolytic disease of the newborn is? destruction of RBCs of the fetus & neonate by AB produced by the mother
Th mother is stimulated to produce ABs by? curent or previous pregnancies or by transfusion
HDN is most commonly caused by anti-D and other Rh blood group ABs
During pregnancy there is fetomaternal hemorrhage which are RBCs from fetus enter the mothers circulation, 0.1ml
Mother forms antibodies against paternal antigens
IgG antibodies cross placenta and bind to fetal RBCs
D hemolytic disease caused by anti-D alone or in combo with anit-C or anti-E
Other hemolytic disease caused by other Rh ABs or blood group ABS, anti-K, anti-c
ABO hemolytic disease usually caused by anti-A,B in O women
FHM occurs in # of pregnancy 75%, usually immediately after delivery
Other causes of FHM amniocentesis, abortion, chorionic villus sampling, cordocentesis,etopic preg, blunt trauma to abdomen
Since advent of Rh immune globulin < 1% of D neg mothers exhibit immunization
Incidence of 'D' HDN = 18% in untreated D neg mothers of D pos infants
Prevalance of non-anti-D HDN = <0.3%
Transfusion of D pos red cell products to women of child bearing age should be avoided
IF D pos transfusion necessary then Rh IG prophylacic treatment
Hemolysis & Erythropoiesis Maternal IgG AB attaches on fetal RBCs; AB/AG complex removed by macrophages in spleen; fetal bone marrow & hempietic tissue in liver & spleen increase RBC production
Anemia moderate to severe depending on #RBCs destroyed; severe anemia may lead to hydrops fetalis from enlarged liver and spleen;
Anemia cont RBC destruction continues after birth as long as maternal AB in system
Hydrops fetalis severe edema, effusions, ascites
Bilirubnemia RBC lysis casuse release of HgB which is metabolized into indirect bikirubin; then may be transported across placenta & conjugated in maternal liver to direct bilirubin & then excreted
Bilirubnemia cont total bili elevated in fetal serum & amniotic fluid, but not harmful; after birth, accumulation of indirect bili to toxic levels & can cause brain damage
Created by: dodge1500