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Hemolytic Disease ( HDN ) of the Newborn

Hemolytic Disease ( HDN ) of the Newborn It is also called erythroblastosis fetalis. This condition occurs when there is an incompatibility between the blood types of the mother and baby. Severe hemolytic disease can cause anemia and heart failure. Less-severe cases include jaundice. When the baby's Rh factor is positive, like the father's, problems can develop if the baby's red blood cells cross to the Rh negative mother.

Babies affected by HDN are usually in a mother's second or higher pregnancy, after she has become sensitized with a first baby. HDN due to Rh incompatibility is about three times more likely in Caucasian babies than African-American babies. This usually happens at delivery when the placenta detaches. It may also happen anytime blood cells of the two circulations mix, such as during a miscarriage or abortion, with a fall, or during an invasive prenatal testing procedure (i.e., an amniocentesis or chorionic villus sampling). This fetal disease ranges from mild to very severe, and fetal death from heart failure ( hydrops fetalis ) can occur. When the disease is moderate or severe, many erythroblasts are present in the fetal blood.

When the mother's antibodies attack the red blood cells, they are broken down and destroyed (hemolysis). This makes the baby anemic. Anemia is dangerous because it limits the ability of the blood to carry oxygen to the baby's organs and tissues.It result is The baby's body responds to the hemolysis by trying to make more red blood cells very quickly in the bone marrow and the liver and spleen. This causes these organs to get bigger.

The new red blood cells, called erythroblasts, are often immature and are not able to do the work of mature red blood cells and the red blood cells break down, a substance called bilirubin is formed. Babies are not easily able to get rid of the bilirubin and it can build up in the blood and other tissues and fluids of the baby's body. This is called hyperbilirubinemia. Because bilirubin has a pigment or coloring, it causes a yellowing of the baby's skin and tissues. This is called jaundice.

Causes of Hemolytic Disease ( HDN ) of the Newborn

Common causes of Hemolytic Disease ( HDN ) of the Newborn

  • Rh factor(Rhesus isoimmunisation ,Rh incompatible fetus ,Rhesus isoimmunisation).
  • Blood transfusion.
  • Hemorrhage.
  • Immune response.
  • Direct Coombs test for the neonate's blood.

Symptoms of Hemolytic Disease ( HDN ) of the Newborn

Common Symptoms of Hemolytic Disease ( HDN ) of the Newborn

  • Heart failure.
  • Pallor.
  • Enlarged liver .
  • Spleen.
  • Swelling.
  • Respiratory distress .
  • Hydrops fetalis(petechiae and purpura).
  • Stillborn.

Treatment of Hemolytic Disease ( HDN ) of the Newborn

Common Treatment of Hemolytic Disease ( HDN ) of the Newborn

  • Exchange transfusion helps increase the red blood cell count and lower the levels of bilirubin. An exchange transfusion is done by alternating giving and withdrawing blood in small amounts through a vein or artery.
  • Intrauterine blood transfusion of red blood cells into the baby's circulation. It may be necessary to give a sedative medication to keep the baby from moving. Intrauterine transfusions may need to be repeated.
  • Respiratory distress using oxygen or a mechanical breathing machine.
  • Maternal anti-D gamma globulin after delivery - to prevent antibodies that may affect a later pregnancy.
  • Prototherapy is help Hemolytic Disease-of-the-newborn.


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