Erythroblastosis Fetalis

King Abdulaziz University Medicine Collage 2009 – 2010 ( 2nd year ) ( Rh–induced Hemolytic Disease of Newborn ) Waleed Faisal Bokhari. 0907069 (Group One ) . Definition: Erythroblastosis Fetalis is a hemolytic anemia in the fetus or neonate, caused by trans-placental transmission of maternal antibodies to fetal RBCs. The disorder usually results from incompatibility between maternal and fetal blood groups, often Rh antigens. Types: ,[object Object]

Rh incompatibility discussed below.Rh incompatibility ( Rh–induced Hemolytic Disease of Newborn ) : Rh incompatibility is that develops when a pregnant woman has Rh-Negative blood and the baby in her womb has Rh-Positive blood. 37216201014303During pregnancy, red blood cells from the fetus can get into the mother’s bloodstream as she nourishes her child through the placenta. If the mother is Rh-Negative blood her system cannot tolerate the presence of Rh-Positive red blood cells. In such case the, the mother’s immune system treats the Rh-Positive fetal cells as if they were a foreign substance and makes antibodies against the fetal blood cells. These anti-Rh antibodies ( Figure 1 ) may cross the placenta into the fetus, where they destroy the fetus’s circulation red blood cells ( Figure 2 ). First-born infants are often not affected because it takes time for the mother to develop antibodies against the fetal blood, unless the mother has had previous mis- carriages or abortions, which could have sensitized her system for developing antibodies. Hence second children who are also Rh-Positive may be harmed. Figure 1 19050106586 Figure 2 Symptoms: ,[object Object]

Polyhydramnios ( before birth )Jaundice 3938978294754Newborn jaundice is a condition marked by high level of bilirubin in the blood. The increase bilirubin cause the infant’s and whites of eyes to look yellow ( Figure 3 ). Before birth, the placenta removes the bilirubin from the infant so that it can be processed by the mother’s liver. Because the hemolytic RBCs of the fetal blood is very high, immediately after birth the baby’s own liver cannot do the normal recycling of old red blood cells, and the rate of bilirubin become higher. Figure 3 3938978127885 Hypotonia ( floppy infants ) It’s a decreased muscle tone ( Figure 4 ) . Infants with hypotonia seem floopy and feel like a “rag doll ” does when held. They rest with their elbows and knees loosely extended, while infants with normal tone tend to have flexed elbow and knees. Head control may be poor or absent, with the head falling to the side, backward or forward. Figure 4 3294400238604 Polyhydramnios It’s the presence of excessive amniotic fluid surrounded the fetus. ( Figure 5 ) Figure 5 Exams and Tests: ,[object Object]

Fetal Blood Sampling ( FBS ) for Rh sensitization during pregnancy.

A high Level of bilirubin in the baby’s cord bloodCoombs’ Test The Coombs’ tes looks for antibodies that may bind to fetal blood cells and causes premature RBC destruction ( hemolysis). The direct Coombs’ test is used to detect antibodies that are already bound to the surface of red blood cells. The indirect test looks for unbound circulating antibodies against a series of standardized red blood cells it’s used to determined if the person have a reaction to blood transfusion. Fetal Blood Sampling ( FBS ) for Rh sensitization Fetal blood sampling (FBS) is the collecting of fetal blood directly from the umbilical cord or fetus. The fetal blood is tested for signs of anemia and other blood problems. FBS is also known as cordocentesis or percutaneous umbilical cord blood sampling. FBS is used to look at a fetus's red blood cell count and oxygen level, and it also looks for signs that your immune system is destroying fetal red blood cells. Prevention: ,[object Object]

Erythroblastosis Fetalis

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