Neonatal immune hemolytic jaundice

Posted by Specialist I Trieu Thi Hong Thai - Neonatologist - Neonatology Department - Vinmec Times City International General Hospital

Neonatal immune hemolytic jaundice occurs as a result of an immune response. The disease can develop into many dangerous diseases such as reticulocytes, anemia, and even stillbirth. Therefore, before planning a pregnancy, parents should have a pre-marital health check, screen for some genetic diseases.

Hemolytic disease of the newborn due to an immune reaction, when maternal IgG antibodies cross the placenta, attach red blood cells in the fetal circulation, breaking down and destroying red blood cells ( or hemolytic).
The fetus can develop reticulocytosis and anemia. The disease ranges from mild to very severe and even stillbirths from heart failure (hydrocephalus) can occur.
In the blood group system, there are 2 common blood group systems, ABO and Rh, in addition to more than 20 other blood group systems. In order of incidence of mother-child blood group incompatibility, the types include: ABO, anti RhD, anti RhE, anti Rhc, anti Rhe, anti RhC, anti Kell...

Children show early jaundice within 24 hours, anemia, hepatosplenomegaly, nuclei of the brain jaundice symptoms when severe: convulsions, aborting, twisting, lethargy...
In fetuses, fetuses signs on ultrasound: anemia, water pregnancy, the worst is stillbirth. On the test can see: positive direct Coombs test (also called direct agglutination test), umbilical cord bilirubin levels, high blood, increased reticulocytes, possibly leukopenia and thrombocytopenia, resistance progenitor erythrocytes, antibodies against maternal erythrocytes.

Some other diseases can cause fetal anemia like other immune hemolysis such as: fetal infection, twin blood transfusion, hemolysis due to abnormal red blood cells (Thalassaemia), viral infection, fetal blood transfusion -Mother... Doctors rely on clinical and laboratory tests to find out the cause of fetal anemia.

The child will be treated according to the severity of breathing, normal blood pressure, anemia status and jaundice.
At birth, the child was assessed for respiration, circulation, and hemolysis: tachycardia, skin color, pleural effusion, heart, abdomen, pulmonary hypoplasia not in those with fetal edema. Children with respiratory failure, low blood pressure will need to be treated in the recovery area, children may need emergency blood transfusions, ... thoracentesis, neutralizing antibodies, even blood changes.
Immediately after birth, the baby will be tested for coombs, hematocrit, reticulocytes, bilirubin, blood group, and phototherapy.

Pre-marital screening and health check-ups help parents screen for genetic diseases and prevent immune hemolysis. In addition, during pregnancy, pregnant women need to have regular antenatal check-ups, follow-up tests, and ultrasound evaluation. Most cases of fetal anemia detected early can support treatment from within the fetus. Mothers with Rh negative blood group are instructed to inject prophylactic anti-D antibodies. Other cases of fetal anemia will be tested, consulted by the prenatal diagnosis committee, found the cause and treated. Up to now, there have been many cases of very severe fetal anemia in Vinmec that have been successfully treated.

As a key area of ​​Vinmec Health system, Pediatrics Department always brings satisfaction to customers and is highly appreciated by industry experts with:
Gathering a team of top doctors and nurses in Pediatrics : consists of leading experts with high professional qualifications (professors, associate professors, doctorates, masters), experienced, worked at major hospitals such as Bach Mai, 108.. Doctors All doctors are well-trained, professional, conscientious, knowledgeable about young psychology. In addition to domestic pediatric specialists, the Department of Pediatrics also has the participation of foreign experts (Japan, Singapore, Australia, USA) who are always pioneers in applying the latest and most effective treatment regimens. . Comprehensive services: In the field of Pediatrics, Vinmec provides a series of continuous medical examination and treatment services from Newborn to Pediatric and Vaccine,... according to international standards to help parents take care of their baby's health from birth to childhood. from birth to adulthood Specialized techniques: Vinmec has successfully deployed many specialized techniques to make the treatment of difficult diseases in Pediatrics more effective: neurosurgery - skull surgery, stem cell transplantation. blood in cancer treatment. Professional care: In addition to understanding children's psychology, Vinmec also pays special attention to the children's play space, helping them to have fun and get used to the hospital's environment, cooperate in treatment, improve the efficiency of medical treatment.