HDNewborn - Hemolytic disease of newborn Dr Tariq M.Roshan...

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Hemolytic disease of newborn Dr. Tariq M.Roshan Dept. of Hematology PPSP
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Objectives Definition & characteristics ABO vs Rh hemolytic disease of the newborn Pathogenesis Incidence Blood types of mother and baby Severity of disease Laboratory data Prevention Rh immune globulin Tests for feto-maternal hemorrhage Exchange transfusion protocol
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Hemolytic disease of newborn Hemolytic disease of the new born and fetus (HDN) is a destruction of the red blood cells (RBCs) of the fetus and neonate by antibodies produced by the mother It is a condition in which the life span of the fetal/neonatal red cells is shortened due to maternal allo-antibodies against red cell antigens acquired from the father
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Antibodies Five classes of antibodies IgM IgG IgA IgD IgE Blood groups specific antibodies are IgG IgM and rarely IgA
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Biochemistry of antibodies Made from four polypeptide chains Two light (L) chains Two identical heavy (H) chains Each class has immunologically distinct heavy chain
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Biochemistry of antibodies IgG1 IgG2 IgG3 IgA IgM IgE Compliment fixation ++ + +++ - +++ - Placental transfer ++ + + - - - Lymphocyte / macrophage FcR binding + - + - - -
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Blood group antibodies Blood group antibodies can be classified as Naturally occurring and immune antibodies Depending on presensitization Cold and warm antibodies Thermal range of antibodies Most natural Abs are cold & some e.g wide thermal range like Anti A and Anti B Most immune Abs are warm and can destroy red cell in-vivo Complete and incomplete antibodies Depends on agglutination of saline suspended red cells IgM is complete antibody; most naturally occurring antibodies are complete and of IgM class IgG is incomplete antibody
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Antibodies of ABO system Anti- A Naturally occurring Immune Anti- B Naturally occurring Immune Anti- A 1 Anti- H
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Antibodies of Rh system Naturally occurring Anti- E Occasionally anti-D and anti C w Immune antibodies D antibodies are more immunogenic Other are anti c, E, e, C.
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