Haemolytic disease of newborn

Abstract

Hemolytic disease of the newborn (HDN) occurs due to maternal IgG antibodies crossing the placenta thereby producing hemolysis mainly due to Rh, ABO and Kell groups. A systematic approach to the Rh HDN involves an obstetric history of previous isoimmunized baby, timing and regular monitoring of maternal Rh antibodies and pigment assay of amniotic fluid. Timely decision regarding in utero transfusion and early termination of pregnancy based on the maternal monitoring has radically improved the outcome of these babies. Antenatal prophylaxis with anti D has resulted in great reduction in the magnitude of Rh problem. The fetal blood sampling and in-utero intravenous transfusions has made it possible for almost 100% survival of isoimmunized pregnancies without hydrops. Alternative methods--IVIG and plasma exchange are still of limited application. ABO HDN though common is not a serious form of disease and dose not warrants invasive antenatal monitoring. Anti-Kell is found in patients having received multiple transfusions and the rapid progress of hemolysis in them may not allow such systematic follow up as in Rh HDN.

Urgent global opportunities to prevent birth defects

“…Lacking prophylaxis, it is estimated that at least one in every six RhD-negative women delivering an RhD-positive baby would be at risk [53]. To understand the racial distribution of this burden, w15% of Caucasians, 3e5% of African-Americans, 8% Asian-Indians, and <1% of Asians have RhDnegative blood groups [50,54,55]. The prevalence of RhD-negative blood group in Europeans is relatively high, and varies between 11% and 21%.…”

Role of minor erythrocyte antigens on alloimmunızation in neonatal indirect hyperbilirubinemia background

“…Kell antikorlari invitro olarak Coombs testi ile gösterilirler. Hemolitik transfüzyon reaksiyonlari ve yenidogan hemolitik hastaligi oluçturabilirler (5,15,12). Minor kan gruplari ile olan ara §tirmalar genellikle hemolitik hastalik saptanan yenidoganlarda bildirilmi §tir.…”

Frequency analysis of B lymphocytes specific for Rh antigens in naturally immunized Rh‐negative women

“…This results in the production of specific immunoglobulin G (IgG) antibodies (Abs) which are able to pass through the placenta and mediate destruction of fetal RBCs, thus causing haemolysis. This process results in a condition known as haemolytic disease of the newborn (HDN) [1,2].…”