Erythroblastosis Fetalis
Erythroblastosis fetalis, also called hemolytic disease of
the newborn, hemolytic disease of the fetus and newborn, HDN, HDFN,
is a blood disorder that the fetus or newborns red blood cells
(RBCs) are being agglutinated by antibodies which are produced by
the mother.
This disease is very preventable, so catching it early is
good for mother and baby. If left untreated, it might kill the
fetus.
BloodTypes
There are eight different types of blood: A+, A-, B+, B-,
AB+, AB-, O+, O-. Blood types are based on the presence or absence
of antigens (also called agglutinogens) which are the substances on
the membrane of the red blood cells (RBCs). These antigens are
either proteins or sugars, depending on the blood group system.
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It is
considered less harmful to the fetus. Sometimes, it even hasnt to
be treated.
Rh Incompatibility
Erythroblastosis fetalis due to the Rh blood group
incompatibility is much severe than ABO incompatibility. This
occurs when a Rh negative mother has a Rh positive baby. In such a
case, the mothers immune system sees the babys Rh positive
antigen as a foreign invader. As a result, the immune system make
antibodies (anti-Rh) to destroy the babys red blood cells.
Normally, Rh incompatibility is not a problem if its a first
pregnancy. However, most problems occur in subsequent pregnancies
with another Rh positive baby. This is because when the first Rh
positive baby is born, the mothers blood creates anti-Rh to
against the Rh factor. During the further pregnancy, these
antibodies cross the placenta and clump the Rh positive cells in
the babys blood.
Symptoms Of Erythroblastosis Fetalis
Anemia
HDN always leads to anemia or low blood count, because of the
prolonged destruction of the red blood cells. Erythroblasts (known
as immature red blood cells) will also present in the babys
circulation. After the baby is born, he or she may have a pale skin
due to the
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Jaundice
Hemolysis also leads to increased bilirubin level, but it is
not a problem before delivery. This is because placenta has the
ability to remove the bilirubin from the babys circulation.
However, after the baby is born, bilirubin cannot be cleared due to
his or her immature liver. As a result, jaundice (skin and eyes
become yellow) happens within 24 hours after the babys birth.
If the level of bilirubin continue to increase, acute or
chronic kernicterus may occur. Kernicterus is an abnormal
accumulation in the brain, and it causes brain tissue damage.
Hepatomegaly and Splenomegaly
The baby with HDN has his or her liver and spleen in a
large-than-normal size. This is because those organs have to
increase their size to produce more red blood cells. Furthermore,
they lose their functions.
Edema
Edema which is known as hydrops is another condition that the
baby with HDN can experience. Fluid accumulates in the heart,
lungs, and abdomen, and causes tissues in these areas start
swollen.
Hydrops fetalis is a fatal condition, and the fetus may die
in the utero or soon after
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