What is Hemolytic Disease?
Hemolytic Disease, also known as
Hemolytic Disease of the Newborn (HDN), is a condition where the red blood cells of a fetus or newborn are destroyed faster than the body can replace them. This occurs due to an incompatibility between the blood types of the mother and her baby, often involving the Rh factor or ABO blood group system.
What Causes Hemolytic Disease?
The primary cause of HDN is an
immunologic reaction where the mother's immune system produces antibodies against the red blood cells of the fetus. This typically happens when an Rh-negative mother becomes sensitized to Rh-positive fetal blood cells, usually during a previous pregnancy, blood transfusion, or miscarriage.
Previous pregnancy with an Rh-positive baby
Blood transfusions
Miscarriage or abortion
Invasive prenatal testing such as amniocentesis
Jaundice (yellowing of the skin and eyes)
Pale appearance due to anemia
Enlarged liver or spleen
Severe cases may result in hydrops fetalis, where the baby develops severe swelling and heart failure.
Blood tests to check the levels of bilirubin and hemoglobin in the baby's blood
Blood type testing of the mother and baby
Coombs test to detect the presence of antibodies against the baby's red blood cells
Ultrasound to monitor the baby for signs of anemia or hydrops fetalis
Phototherapy to treat jaundice
Intrauterine blood transfusions for the fetus
Early delivery if the baby is mature enough
Postnatal blood transfusions for severe anemia
How Can it be Prevented?
Prevention of HDN primarily involves the administration of Rh immunoglobulin (RhIg) to Rh-negative mothers:
RhIg is given during pregnancy and after delivery if the baby is Rh-positive.
It is also administered after any event where fetal blood might mix with maternal blood, such as miscarriage, abortion, or invasive prenatal testing.
What is the Prognosis?
The prognosis for infants with HDN has improved significantly due to advances in medical treatment. Early diagnosis and appropriate management can result in good outcomes for affected babies. However, severe cases with complications like hydrops fetalis may have a poorer prognosis.
When to Seek Medical Advice?
Parents should seek medical advice if they notice symptoms such as jaundice, pale appearance, or an enlarged abdomen in their newborn. Early intervention can prevent complications and improve the baby's health outcomes.
