IMH LEC - LESSON 5: Hemolytic Disease of the Fetus and Newborn

What is the disease that causes the destruction of the RBCs of a fetus neonate by antibodies produced by the mother?

Hemolytic Disease of the Fetus and Newborn (HDFN)

Alternative name for HDFN

Erythroblastosis fetalis

Term for the leakage of the RBC of the fetus to the maternal circulation

Fetal maternal Hemorrhage

Enumerate the factors affecting immunization & severity of HDFN

1. Antigenic exposure
2. Host factors
3. Immunoglobulin class
4. Antibody specificity
5. Influence of the ABO blood group

Enumerate the 3 most important factors for HDFN to occur

1. RBC produced by the mother must be IgG
2. Fetus must posses an antigen that is lacking in the mother (Antigen D)
3. Antigen D must be well developed at birth

When does Hemolysis occur during HDFN?

When maternal IgG attaches to specific antigens of the fetal RBCs

Term for enlarged Spleen

Splenomegaly

Term for enlarged Liver

Hepatomegaly

Term for when the spleen and liver are stressed to produce more RBCs to compensate for anemia, causing them to enlarge

Hepatosplenomegaly

Enumerate the Serological tests possible to be done to the mother

* ABO, Rh Typing
* Antibody Screening
* Antibody Identification
* Antibody Titration

Test that uses a sample of the baby's blood from the umbilical cord

Cordocentesis

Alternative name for Cordocentesis

Percutaneous Umbilical Blood Testing

Test that uses a sample of the baby's blood from the amniotic sac/fluid

Amniocentesis

Procedure that accesses the fetal umbilical vein to inject donor RBCs directly

Intrauterine Transfusion

Cut off value of Fetal hemoglobin to keep a baby alive

10 g/dL

What Blood group do most centers treating HDFN use?

Blood type O

Reason for the use of Blood group O to treat HDFN

Blood group O does not have any antigens in its Red cell

Procedure performed to remove BILIRUBIN from the ciruclation of the baby

Phototherapy

Condition caused by the accumulation of bilirubin on the brain of the fetus

Kernicterus

Which Rh group prevents immunization to D antigen?

RhIG (Rhogam)

When is Rhogam prescribed?

* 28th week of Gestation
* 72 hours AFTER birth

Test performed to detect for fetomaternal hemorrhage

Rosette Testing

What should be done if Rosette Test results to positive?

Kleihauer-Betke Acid Elution Test