Hemolytic disease is a disease that is caused by the incompatibility of the blood of the mother and the unborn baby for various antigens. There is incompatibility and Rh factor. This often happens when the mother and the fetus have a different Rh factor (for example, the mother is positive, the fetus is negative or vice versa). In case of group incompatibility, the mother and the fetus may have different blood groups (for example, the mother group 0 (1), and the fetus any other). Hemolytic disease of newborns can develop with the incompatibility of other blood antigens, but this happens extremely rarely.
What are the reasons?
Hemolytic disease in women with negative rhesus is quite common. This is a very serious and dangerous disease. The process of rhesus conflict is simple: antigens come from the fetus to the mother through the placenta. In response to this, the woman’s body produces its own Rh-negative antibodies to destroy the opposite Rh-positive red blood cells of the unborn baby, thereby destructively acting on its liver, spleen, bone marrow and blood-forming organs. Thus, destroyed red blood cells lead to the accumulation of bilirubin in the tissues of the fetus, which has a toxic effect on the brain of the baby. The Rhesus factor is determined in the blood of the child already in the third month of fetal development. It was from this time that his “conflicts” with his mother began.
Hemolytic disease of the newborn. Symptoms
To date, three forms of this insidious disease have been studied: edematous, icteric and anemic. The most severe is the edematous form, with it, children are born prematurely or die immediately after birth. In this case, the appearance of the newborn has a characteristic appearance: a moon-shaped face, waxy pallor, sometimes cyanosis or yellowness, subcutaneous tissue edematous. There is free fluid in the pleural, abdominal, pericardial cavities, sometimes bruising, petechiae. The baby’s liver and spleen are enlarged. In the blood there is a decrease in red blood cells and hemoglobin, as well as leukocytosis, erythroblastosis, reticulocytosis.
Hemolytic jaundice of newborns is mild, moderate and severe. It is characterized by the appearance of jaundice immediately after the birth of the fetus or several hours later. At the same time, even amniotic fluid can be colored yellow. Hemolytic jaundice in a baby grows very quickly, the liver and spleen increase, a tendency to bleeding is observed. Such babies are born lethargic, do not suckle well, all physiological reflexes in them can be reduced. In the blood, the level of bilirubin rises and on the third or fifth day reaches its maximum. If at this moment the child is not treated, nuclear jaundice develops . Intracranial hypertension, tonic cramps, stiff neck, tremor of the extremities appear. Characteristic for this type of disease is the tone of the extensor muscles of the hands, while general hypotension is increasing.
Anemic form is the easiest manifestation of this disease. With it, an increase in the liver and spleen is observed, the number of red blood cells and hemoglobin in the blood decreases.
Hemolytic disease of the newborn. Treatment
The most important thing in therapeutic measures is the speedy detoxification of the body of the newborn, the removal of the decay products of red blood cells, antibodies and bilirubin. All this is done in order to stop the hemolysis of red blood cells in the baby’s blood after birth. During this period, the child is shown plenty of water, vitamins, enterosorbents, detoxification solutions. Severe anemia is an indication for an exchange blood transfusion.
In order to prevent hemolytic disease, modern medicine transfuses blood and its components strictly according to emergency indications in order to prevent a woman from being immunized with foreign antigens. In the case when a pregnant woman has a Rhesus conflict, she is hospitalized and does everything possible to maintain the health and life of the baby.