HAEMOLYTIC DISEASE OF FETUS AND NEWBORN

Haemolytic Disease of Fetus and Newborn

Haemolytic Disease of Fetus and Newborn

Chapter 1

1.1 Introduction

During pregnancy a RH+ child, whose red cells passed into the maternal circulation. In the latter case, the passage of the baby's red blood cells into the bloodstream of the mother occurs during pregnancy, but especially during childbirth, when there are breaks in the placenta, favoring the passage of erythrocytes with Rh factor baby, for the mother who is RH-. Thus, after this contact, the mother's body will begin to produce anti-Rh antibodies, acquired immune memory. As the production of Rh antibodies is very slow, the first child will not be born with any kind of problem.

If there is a second pregnancy, and the child is RH+, the mother's body stimulate the production of anti-Rh antibodies that cross the placenta and cause destruction of fetal red blood cells, causing anemia in the newborn. This child will also deposition of bilirubin, a substance produced by the liver of the baby from the hemoglobin from red blood cells destroyed by anti-Rh antibodies, causing jaundice (yellow skin). The deposition of bilirubin in the brain can cause severe and irreversible injuries. There are cases in which serious miscarriage occurs.

In response to anemia, are produced and released into the blood erythrocytes immature erythroblasts calls coming hence the name of the disease. For the woman to prevent this disease is necessary for her to receive an intravenous injection with anti-Rh antibodies at birth, or up to three days after delivery. These antibodies destroy the red blood cells quickly left by RH+ baby and entered the bloodstream of the mother, thus preventing sensitization that occurs in the body of the mother and the consequent production of antibodies.

The maternal-fetal blood incompatibility is in the majority of cases related to the system Rh (D antigen), appearing when a mother has Rh negative Rh positive fetus. The situation can be considered high risk, because it presents risk to both mother and the fetus. The transmission of the Rh factor and genetics, it being transmitted by one dominant gene. The D antigen will be present, then both sdangue as a heterozygote in the blood of homozygous. Only one fetus that has no gene Rh gift will be Rh negative. The basic incompatibility of fetal-maternal immunity and who exercises against the fetal red blood cells - which are perceived as foreign, antibodies trying to neutralize them. The hemolysis and the final effect and the increase in hemoglobin degradation products (bilirubin).

Not only this affected the fetus, but also the mother. Today, there are more accidents maternal put into doubt, and the incidence of an accident hemolytic / 5-6 Rh incompatibility. The clinical picture is represented the mother of a pseudo-toxemic syndrome that is refractory to any treatment. Although there are many investigations that can be used for diagnosis and prognosis of hemolytic disease of the fetus, the future of a pregnancy can be decided only after assessing the level of bilirubin in the amniotic fluid - therefore ...