A hemolytic disease is a complication of a serological conflict. The first child out of a serological conflict is usually safe, but the next one is at risk of serious problems - neonatal haemolytic disease. Therefore, anyone who wants to have a child should perform a simple test to determine the blood group and Rh factor. If a woman is Rh- and her partner is Rh +, the pregnancy must be under special surveillance.

Hemolytic diseaseis associated withserological conflict.The latter can be spoken of when the mother is Rh- and the father is Rh +, and it is from him that the child will inherit blood. The Rh negative woman's blood cells can then be released into the bloodstream of the Rh negative woman. The mother's immune system will then protest: it considers the fetal blood cells to be "foreign" (like bacteria that enter the body from the outside) and treats them as an intruder. Antibodies will start to be produced which will destroy the baby's blood cells.

Fortunately, this problem does not appear in the first pregnancy. Why? Because the "mixing" of the mother's and baby's blood, and thus the production of antibodies, is only possible during labor, when the placenta separates from the uterine wall.

Hemolytic disease - causes

The first child born of a conflict is usually safe. But when a woman becomes pregnant again (and the baby also inherits Rh + from her father), the antibodies produced in her body are activated. They travel through the placenta into the fetal bloodstream and damage its red blood cells - a haemolytic disease of the newborn.

In less severe cases, the hemolytic disease of the newborn causes slight anemia, and in more serious cases - even the death of the baby in the womb or severe postpartum jaundice with enlarged liver and spleen.

If the level of antibodies is a threat to the baby, it can be transfused through the umbilical cord while still in the womb. However, the so-called replacement of blood through the umbilical cord right after birth. This is the case when the newborn's bilirubin level exceeds 150 mg per liter of blood.

Hemolytic disease - symptoms

  • Hemolytic disease with anemia

In the course of this mildest form of haemolytic disease, it is destroyedof your baby's blood cells, resulting in anemia. It may also have an enlarged liver and spleen. Then the disease does not threaten his life.

  • Hemolytic disease with jaundice

Jaundice appears on the first day after delivery (the physiological one does not appear earlier than on the second day of life). Blood tests show that the levels of bilirubin, the pigment responsible for the yellow color of the skin, are very high. In excess, it is toxic to the child's brain, therefore this form of the disease endangers its he alth (it may lead to mental disorders, epilepsy, problems with speech) and even life. Accompanying symptoms are convulsions and increased muscle tension.

  • Haemolytic disease with fetal generalized edema

It is the most severe form of the disease, in the course of which the child's circulation and vascular permeability are disturbed. Fluid from the vessels flows into adjacent tissues, causing the development of life-threatening swellings.

Hemolytic disease - diagnosis

Initial diagnostics are performed at the beginning of each pregnancy. Then the doctor orders a test to determine the mother's blood group and antibody titre.

The second stage of haemolytic disease diagnosis is to perform fetal morphology. In addition, the parameter of the maximum velocity of blood flow through the artery of the fetal brain is assessed.

The third and last stage of diagnostics is the biochemical and serological tests of the baby, which are performed after its birth.

Hemolytic disease - treatment

During pregnancy, the doctor may decide to transfuse intrauterine blood that is insensitive to maternal antibodies. However, after delivery, phototherapy is used to lower the bilirubin level. In severe cases, umbilical cord replacement blood transfusion is required immediately after birth.

How to prevent serological conflict?

If a pregnant woman has Rh- blood, she should have blood tests for serum antibodies in addition to routine checks. To prevent serological conflict, a Rh-blooded woman is given a special immunoglobulin (anti-D) within 72 hours after each delivery (or miscarriage), which blocks the production of antibodies. Thanks to this, the next baby will be safe in the mother's womb.

Serological conflict: watch the video

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