What you need to know about Erythroblastosis fetalis.
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Erythroblastosis Fetalis/Hemolytic Disease of the New Born (HDN).
What is HDN?
HDN is an alloimmune condition that develops in a fetus, when the IgG molecules produced by the mother pass through the placenta. It is a blood disorder in a fetus or a neonate. In some neonates, it can be life threatening because the red blood cells which are normally destroyed in 120 days will now be destroyed earlier than normal.
Causes of HDN
This occurs when the immune system of the mother sees the fetus red blood cells as foreign because during pregnancy, it is normal for the fetus' red blood cells to cross into the mother's blood through the placenta. When the mother's immune system sees the baby's red blood cell as foreign, antibodies then develop against the baby's red blood cells. These antibodies attack the red blood cells of the baby's blood and cause them to break down too early.
HDN can also develop when a mother and her fetus have different blood types. The types are based on molecules on the surface of the red blood cells. There are 2 ways that the unborn baby's and mother's blood may not match: The 4 major blood types A, B, AB and O is the most common form of a mismatch. In most cases, this is not very severe.
If the mother is rhesus-negative and the unborn baby has rhesus-positive cells. When this form does occur, it can cause very severe anemia in the baby. Even though it can be prevented in most cases.
Signs and symptoms
HDN can destroy the fetus blood cells very quickly which can cause symptoms like
1. Edema (swelling under the surface of the skin)
2. Newborn jaundice which occurs sooner and more severe than normal
Signs include: anemia or low blood count, enlarged liver or splenomegaly , hydrops (fluid throughout the body's tissues, including in the spaces containing the lungs, heart and abdominal organs) which can lead to heart failure and /or respiratory failure from too much fluid.
Diagnosis
Complete blood count, bilirubin level, blood typing.
Treatment
Regular feeding and receiving extra fluids, light therapy (phototherapy), antibodies (intravenous immunoglobulin or IVIG) to help protect the baby's red cells from being destroyed, in severe cases, an exchange transfusion may need to be performed.
Prevention
The most severe form of this disease , which is caused by rhesus incompatibility, can be prevented if the mother is tested during pregnancy. If needed, she is given a shot of RhoGAM at certain times during and after pregnancy.
Written by: Eluwa Kelechi.
Erythroblastosis Fetalis/Hemolytic Disease of the New Born (HDN).
What is HDN?
HDN is an alloimmune condition that develops in a fetus, when the IgG molecules produced by the mother pass through the placenta. It is a blood disorder in a fetus or a neonate. In some neonates, it can be life threatening because the red blood cells which are normally destroyed in 120 days will now be destroyed earlier than normal.
Causes of HDN
This occurs when the immune system of the mother sees the fetus red blood cells as foreign because during pregnancy, it is normal for the fetus' red blood cells to cross into the mother's blood through the placenta. When the mother's immune system sees the baby's red blood cell as foreign, antibodies then develop against the baby's red blood cells. These antibodies attack the red blood cells of the baby's blood and cause them to break down too early.
HDN can also develop when a mother and her fetus have different blood types. The types are based on molecules on the surface of the red blood cells. There are 2 ways that the unborn baby's and mother's blood may not match: The 4 major blood types A, B, AB and O is the most common form of a mismatch. In most cases, this is not very severe.
If the mother is rhesus-negative and the unborn baby has rhesus-positive cells. When this form does occur, it can cause very severe anemia in the baby. Even though it can be prevented in most cases.
Signs and symptoms
HDN can destroy the fetus blood cells very quickly which can cause symptoms like
1. Edema (swelling under the surface of the skin)
2. Newborn jaundice which occurs sooner and more severe than normal
Signs include: anemia or low blood count, enlarged liver or splenomegaly , hydrops (fluid throughout the body's tissues, including in the spaces containing the lungs, heart and abdominal organs) which can lead to heart failure and /or respiratory failure from too much fluid.
Diagnosis
Complete blood count, bilirubin level, blood typing.
Treatment
Regular feeding and receiving extra fluids, light therapy (phototherapy), antibodies (intravenous immunoglobulin or IVIG) to help protect the baby's red cells from being destroyed, in severe cases, an exchange transfusion may need to be performed.
Prevention
The most severe form of this disease , which is caused by rhesus incompatibility, can be prevented if the mother is tested during pregnancy. If needed, she is given a shot of RhoGAM at certain times during and after pregnancy.
Written by: Eluwa Kelechi.
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