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Hemolytic Disease of the Newborn: Causes, Symptoms & Treatment

Instructor: Artem Cheprasov

Artem has a doctor of veterinary medicine degree.

This lesson goes over the fundamentals of hemolytic disease of the newborn. You'll learn about its cause, signs and consequences, as well as major treatment options.

Hemolytic Disease of the Newborn

Do you know what blood type you have? It's either A, B, AB, or O. Do you know if it's Rh-positive or Rh-negative? Rh factor is a kind of protein found on red blood cells. If you have it, then you're Rh-positive. If you don't, then you're Rh-negative. Simple enough.

What's not so simple is the dynamics of hemolytic disease of the newborn, more broadly called hemolytic disease of the fetus and newborn, since both can be affected. In short, this is a condition that destroys a baby's red blood cells. This lesson will describe the basics of this condition, its signs, and treatment.

Causes

Although there are other variations of hemolytic disease of the newborn, the one situation most likely to produce a severe version of this condition is when the mother is Rh-negative and the fetus is Rh-positive.

During pregnancy, there is a chance fetomaternal hemorrhage will occur. This is where a baby's red blood cells enter the mother's circulation. The problem is that the mother's immune system may recognize the Rh-positive red blood cells from the fetus as something foreign that shouldn't be in her body.

In turn, this means the mother's immune system will produce antibodies that target the fetal red blood cells. Antibodies are proteins that neutralize, destroy, or signal other cells to destroy whatever it is that they attach to. In this case, they're produced by the mother's immune system to attach to the baby's red blood cells. The type of antibody class that is most involved in hemolytic disease of the newborn is known as IgG.

The mother's antibodies then cross the placenta and enter fetal circulation, where they understandably attach to the baby's red blood cells. This ends up destroying the red blood cells. At this point, the condition's name should make sense, since the term hemolytic, in hemolytic disease of the newborn, comes from:

  • hemo-, which refers to blood
  • -lytic, which refers to the destruction of something

Signs & Consequences

The signs and consequences of fetomaternal hemorrhage can be influenced by numerous factors, including how many pregnancies the mother has had and what kind of specific blood mismatch between the mother and fetus has occurred. Possible signs and consequences include:

  • Anemia, or a lack of red blood cells
  • Jaundice, which is the yellowing of the skin, whites of the eyes, and mucous membranes
  • Pale skin
  • An enlarged spleen
  • An enlarged liver
  • Abnormal amounts and accumulations of fluids, such as in the chest or abdomen

Treatment

Children born with this condition may require numerous interventions. For example, they may receive light therapy to help them convert a pigment released by destroyed red blood cells, called bilirubin, into a form their body can get rid of. This will also help get rid of the jaundice caused by the high levels of bilirubin.

The baby can also be given something called intravenous immunoglobulin. In short, the baby is injected with good antibodies that actually shield the baby's red blood cells from destruction.

A transfusion can also be employed. Here, the baby's blood is removed and donor blood is placed back into the baby's body. This procedure helps lower the baby's bilirubin level and helps get rid of the bad antibodies as well. It also helps to improve the baby's red blood cell count and thus counter the anemia.

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