Hemolytic disease of the neonate

The article was written by Specialist Doctor I Trieu Thi Hong Thai - Neonatology Department - Vinmec Times City International General Hospital.

The fetus can develop reticulocytosis and anemia. The disease ranges from mild to very severe, and fetal death from heart failure (hydrocephalus) can occur. Causes of hemolysis can include: mother-child blood group incompatibility ABO, or due to anti RhD, anti RhE, anti Rhc, anti Rhe, anti RhC, anti Kell...

Children may have 1 or more of the following manifestations:
Jaundice as early as 24 hours Anemia Hepatosplenomegaly Symptoms of severe nuclear jaundice: such as torsion convulsions, increased muscle strength In the fetus: fetal symptoms present anemia, severe fetal edema, water pregnancy, stillbirth

Children with symptoms will be tested to diagnose the cause and severity of the disease such as:
Positive direct Coombs test (also known as direct agglutination test) Concentration of bilirubin in the cord blood, or high in blood Reticulocytes may increase leukopenia and thrombocytopenia Child red cell antigen Antibodies to maternal red blood cells

The treatment depends on the severity of the baby and the cause of the disease:
At birth: assess the baby's respiratory and circulatory capacity as well as assess the degree of hemolysis: such as tachycardia, pale skin, respiratory failure aspiration (excluding pleural effusion, pulmonary hypoplasia) in cases of fetal edema? Fetus with edema: there may be shock or pre-shock at birth, the baby may need an emergency blood transfusion, pleural puncture/aspiration, peritoneal aspiration. When the circulation is stable, the child may need a blood exchange if indicated. Children with symptoms of anemia but stable blood pressure: Children are consulted, treatment may need: blood exchange, antiserum transfusion, blood transfusion, phototherapy, respiratory support treatments if necessary. Late cases of anemia: children are treated with iron, possibly with drugs that stimulate red blood cells.

Strict pregnancy control is an important measure: The cases of pregnant women with a history of stillbirth, fetal edema... will be evaluated and examined by an obstetrician-gynecologist to rule out related causes. to hemolytic anemia. Checking the mother's blood group is necessary to predict the risk of hemolytic jaundice in the baby, and in the future babies (because the next baby has a higher risk of jaundice and is more severe than the previous baby). However, many cases of severe hemolysis due to incompatibility of blood groups under the ABO, Rh system: such as kell, Rhe, Rhe systems, etc. It is very important to manage the baby after birth, and re-examination is very important in the first week after birth. Vinmec International General Hospital is one of the hospitals that not only ensures professional quality with a team of leading medical professionals, a system of modern equipment and technology. The hospital provides comprehensive and professional medical examination, consultation and treatment services, with a civilized, polite, safe and sterile medical examination and treatment space. Customers when choosing to perform tests here can be completely assured of the accuracy of test results.