Expectant parents may be familiar with the professional term \”hemolytic disease of the newborn\”. But under what circumstances will a baby suffer from hemolytic disease of the newborn? The editor will reveal the answer to you right away.
Among the Han population in my country, the incidence rate of neonatal hemolysis caused by ABO blood type incompatibility is the highest. Clinically, more than 90% occur in pregnant mothers with type O blood and husbands with type A, B or AB blood.
Hemolytic disease of the newborn is also known as \”hemolytic disease of maternal and fetal blood group incompatibility\”. Hemolytic disease in children.
How does hemolysis occur?
Under normal circumstances, there is a natural barrier between the pregnant mother and the fetus, which is the placenta. This barrier protects most components of the blood between the mother and fetus from direct contact. However, a small amount of fetal blood components will still seep into the pregnant mother\’s blood through the placenta; at the same time, a small amount of components in the pregnant mother\’s blood will also enter the fetus. The incompatibility of the two components will lead to fetal hemolytic reaction.
Usually, in most cases where the blood types of mother and baby are incompatible, the degree of hemolytic reaction is relatively mild. After the baby is born, the blood components of the pregnant mother\’s incompatible blood types will be slowly metabolized and consumed over a period of time, and the baby will soon return to normal. . Therefore, pregnant mothers with type O blood can conceive and give birth as usual.
Only in a few cases, when a large amount of components in the pregnant mother\’s blood that are incompatible with the fetus pass through the placenta and enter the fetus, will it cause severe neonatal hemolysis.
Abo hemolytic disease mostly occurs when giving birth to a second child, but 40% to 50% of Abo hemolytic disease occurs in the first child, so pregnant mothers with type O blood should especially cherish their first child.
Neonatal jaundice is different from hemolytic disease
Symptoms of neonatal hemolysis range from mild to severe. Generally, babies will develop a certain degree of jaundice from the second day after birth. Mommy will find that the baby\’s head, face or chest and abdomen will appear a lemon-yellow color; jaundice will deepen after 46 days; about 10 days after birth, it will gradually subside and return to normal.
If skin jaundice develops rapidly within 24 hours to 3 days after birth, or even spreads to the whole body, and the color changes from light yellow to dark yellow, you should be alert to hemolytic disease of the newborn.
harm
Extensive hemolysis can cause severe anemia and even heart failure;
Severe anemia, hypoalbuminemia, and heart failure can cause fetal hydrops;
Anemia can also cause compensatory proliferation of extramedullary hematopoietic tissue, leading to hepatosplenomegaly;
A large amount of unconjugated bilirubin produced by hemolysis passes through the blood-brain barrier and turns the brain nuclei yellow, causing visual impairment, deafness, dental hypoplasia, mental retardation, epilepsy and other sequelae, that is, bilirubin encephalopathy, but it generally does not occur without hemolysis. Such serious consequences.
treat
Once neonatal hemolysis is found, it can be treated through neonatal exchange transfusion therapy, blue light therapy and other methods, and generally satisfactory results can be achieved.
prevention
Since the selection of fetal blood group genetic material is uncontrollable, there is currently no fundamental way to prevent mother-child blood group incompatibility, but intervention can be done through pre-pregnancy and prenatal examination and treatment to prevent the occurrence of severe blood group incompatibility. Hemolytic disease of the newborn. In addition, cherishing the first child and avoiding multiple blood transfusions are also important in preventing hemolytic disease of the newborn.
1. Pre-pregnancy check-up
The couple both went to the hospital to have their blood types checked. Couples with incompatible blood types should measure antibodies and their titers in the blood of pregnant women. It is only meaningful when the titer is 1:64, indicating that abo hemolysis may occur after pregnancy.
2. Prenatal check-up Pregnant mothers with a history of blood transfusion, miscarriage, delivery and severe jaundice should undergo prenatal blood type and blood type antibody tests. Starting from about 16 weeks of pregnancy, blood antibodies should be tested regularly: usually once every 4 weeks; between 28 and 32 weeks of pregnancy, it should be measured every 2 weeks; after 32 weeks of pregnancy, it should be measured once a week.
If the titer is found to be significantly elevated during serial examinations, it often indicates that the fetus has been infected.
If the titer drops significantly in late pregnancy, it indicates that the fetus has been hemolyzed. At this time, the degree of fetal hemolysis and edema should be estimated through amniotic fluid examination and ultrasound examination.
3. Prenatal treatment
If fetal hemolysis is diagnosed, treatment can be carried out through maternal plasma exchange, premature delivery and other methods. Early diagnosis and treatment can effectively prevent the occurrence of hemolytic disease of the newborn.
Special Note:
If the mother has high antibodies, her newborn baby\’s symptoms may not necessarily be severe. The severity of hemolytic disease is sometimes not directly proportional to the level of antibodies. This is related to the difference in the baby\’s own body constitution.
In addition, pregnant mothers with type O blood do not need to be too nervous during delivery. Jaundice does not mean that the baby has hemolysis. Generally speaking, about 80% of newborns will develop jaundice, and only a small number of them are caused by hemolysis.