Book contents
- Frontmatter
- Contents
- List of contributors
- Foreword (1)
- Foreword (2)
- Preface
- Acknowledgments
- Section 1 Organization of neonatal transport
- Section 2 Basics in cardiopulmonary resuscitation of newborn infants
- Section 3 Classic and rare scenarios in the neonatal period
- Management of healthy, term newborn infants (vaginal delivery, cesarean section, vacuum extraction, forceps delivery)
- Management of preterm and moderately depressed term newborn infants with a birth weight ≥1500 g
- Management of very preterm newborn infants (VLBW, ELBW)
- Twin–twin (feto–fetal) transfusion syndrome
- An apparently trivial call from the term baby nursery
- Out of hospital birth
- Hypoglycemia
- Meconium aspiration
- Chorioamnionitis and early-onset sepsis in the newborn infant
- Perinatal hemorrhage
- Perinatal hypoxia-ischemia
- Cerebral seizures
- Infants born to mothers on psychoactive substances
- Prenatal and postnatal arrhythmias
- Critical congenital cardiovascular defects
- Patent ductus arteriosus of the preterm infant
- Persistent pulmonary hypertension of the newborn (PPHN)
- Congenital diaphragmatic hernia
- Pneumothorax
- Congenital cystic adenomatoid malformation of the lung (CAM, CCAM)
- Chylothorax
- Hemolytic disease of the newborn
- Hydrops fetalis
- Choanal atresia
- Esophageal atresia
- Gastrointestinal obstruction
- Necrotizing enterocolitis (NEC)
- Omphalocele and gastroschisis
- Neural tube defects
- Cleft palate
- Birth trauma: brachial plexus palsy, facial nerve palsy, clavicular fracture, skull fracture, intracranial and subperiosteal hemorrhage (cephalohematoma)
- Sudden infant death syndrome (SIDS)
- Questions for review
- References (Section 3)
- Section 4 Transport
- Section 5 Appendix
- Index
- Plate section
Hemolytic disease of the newborn
from Section 3 - Classic and rare scenarios in the neonatal period
Published online by Cambridge University Press: 05 March 2012
- Frontmatter
- Contents
- List of contributors
- Foreword (1)
- Foreword (2)
- Preface
- Acknowledgments
- Section 1 Organization of neonatal transport
- Section 2 Basics in cardiopulmonary resuscitation of newborn infants
- Section 3 Classic and rare scenarios in the neonatal period
- Management of healthy, term newborn infants (vaginal delivery, cesarean section, vacuum extraction, forceps delivery)
- Management of preterm and moderately depressed term newborn infants with a birth weight ≥1500 g
- Management of very preterm newborn infants (VLBW, ELBW)
- Twin–twin (feto–fetal) transfusion syndrome
- An apparently trivial call from the term baby nursery
- Out of hospital birth
- Hypoglycemia
- Meconium aspiration
- Chorioamnionitis and early-onset sepsis in the newborn infant
- Perinatal hemorrhage
- Perinatal hypoxia-ischemia
- Cerebral seizures
- Infants born to mothers on psychoactive substances
- Prenatal and postnatal arrhythmias
- Critical congenital cardiovascular defects
- Patent ductus arteriosus of the preterm infant
- Persistent pulmonary hypertension of the newborn (PPHN)
- Congenital diaphragmatic hernia
- Pneumothorax
- Congenital cystic adenomatoid malformation of the lung (CAM, CCAM)
- Chylothorax
- Hemolytic disease of the newborn
- Hydrops fetalis
- Choanal atresia
- Esophageal atresia
- Gastrointestinal obstruction
- Necrotizing enterocolitis (NEC)
- Omphalocele and gastroschisis
- Neural tube defects
- Cleft palate
- Birth trauma: brachial plexus palsy, facial nerve palsy, clavicular fracture, skull fracture, intracranial and subperiosteal hemorrhage (cephalohematoma)
- Sudden infant death syndrome (SIDS)
- Questions for review
- References (Section 3)
- Section 4 Transport
- Section 5 Appendix
- Index
- Plate section
Summary
Syndrome/definition/pathophysiology/epidemiology
Hemolytic disease of the newborn (HDN) is also known as erythroblastosis fetalis, isoimmunization, or blood group incompatibility
HDN occurs when fetal red blood cells (RBCs), which possess an antigen that the mother lacks, cross the placenta into the maternal circulation, where they stimulate antibody production. The antibodies return to the fetal circulation and result in RBC destruction
Rhesus positive (+) denotes presence of the D antigen. The number of antigenic sites on RBCs varies with the genotype, and the prevalence of the genotype varies with the population. In the USA, Rhesus-negative (d/d) individuals comprise 15% of Whites, 5.5% of African Americans, and <1% of Asians. A sensitized Rhesus-negative mother produces anti-Rh IgG antibodies which cross the placenta. Risk factors for antibody production include prior miscarriage or abortion, second (or later) pregnancies, maternal toxemia, paternal zygosity (D/D rather than D/d), and amount of antigen load
With maternal blood types A and B, isoimmunization does not occur because the naturally occurring antibodies (anti-A and -B) are IgM, not IgG. In type-O mothers, the antibodies are predominantly IgG, cross the placenta, and can cause hemolysis in the fetus. The association of a type-A or B fetus with a type-O mother occurs in ~15% of pregnancies. However, HDN occurs in only 3%, is severe in only 1%, and <1:1000 require exchange transfusion. Unlike Rh, ABO disease can occur in first pregnancies, because anti-A and anti-B antibodies are found early in life from exposure to A- or B-like antigens present in many foods and bacteria
- Type
- Chapter
- Information
- Neonatal Emergencies , pp. 423 - 426Publisher: Cambridge University PressPrint publication year: 2009