Hemolytic disease of the newborn - occurs on the basis of isoimmunization, which develops on the basis of incompatibility between maternal and fetal blood Rh factor, its subtypes, blood groups. Hemolytic disease frequently occurs as a result of Rhesus-conflict.
Hemolytic disease develops in utero. Rh factor, contained in red blood cells and fetal inherited from his father, falls into the mother's blood. On the foreign antigen to it, the mother's body reacts to the formation of anti-Rhesus antibodies. Some of these antibodies again passes through the placenta into the fetal blood and causes hemolysis.
Less commonly, hemolytic disease is caused by blood group incompatibility between mother and fetus.
Hemolytic disease of the newborn occurs in three forms:
edematous
icteric
anemic.
Edematous form of the most difficult. Children are often born prematurely, dead, or dying in the first minutes or hours after birth. Characterized by the appearance of the newborn: waxy pallor, jaundice, or sometimes light cyanotic skin, moon face, edema of the total subcutaneous fat, free fluid in the cavities (pleural, pericardial, peritoneal), bruising, petechiae. The spleen and liver are enlarged. In the blood was a sharp decline in hemoglobin and red blood cells, erythroblastosis, leukocytosis, reticulocytosis.
Icteric form can be severe, moderate and mild. In severe characterized by the appearance of jaundice at birth or within a few hours. Amniotic fluid and original mask can be painted in yellow.
Jaundice increases rapidly acquires a yellow-green, sometimes yellow-brown. The liver and spleen are enlarged. There is a tendency to bleeding, children are flabby, ill suck physiological reflexes are reduced. Jaundice lasts up to 3 weeks or more. The bilirubin level increases rapidly. To 3-5 day bilirubin in the blood reaches a maximum.
In the absence of adequate therapy develops kernicterus. Develops intracranial hypertension (stiff neck, tonic spasms, tremor of the limbs). A characteristic feature is the predominance of the extensor tone hands against the general hypotension. The child is with your mouth open, his face masklike. Characterized by a monotonous muffled cry, at first glance fixed frozen, then a symptom of "sunset."
Anemic form - the most mild form. The spleen and liver are enlarged. In the blood, decreased hemoglobin and red blood cells, microcytosis, anisocytosis, reticulocytosis. The main method of treatment is to replace blood transfusions.
