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Saturday, September 24, 2016


Hemolytic Disease of the Newborn

Hemolytic Disease of the Newborn

During a pregnancy in which the mother is Rh- and the fetus Rh+, total red cells sensitize the mother who produces anti-Rh antibodies. The maximum risk of sensitization occurs during delivery of the baby when large numbers of the infant's red cells escape through the placenta into the mother's blood.

Therefore first pregnancies are not usually harmful to the infant. During subsequent pregnancies, maternal IgG anti-Rh antibodies cross the placenta and lead to the destruction of the infant's Rh+ red cells.  Severe hemolytic anemia of the newborn child or intrauterine death can result.

Administration of anti-Rh antibodies prevents sensitization of the mother by the destruction of Rh+ fetal red cells that enter the maternal circulation. The antiserum produced by human volunteers is administered shortly after delivery of the baby (the time of maximum of risk of sensitization.) 

The maternal red cells are Rh- and are unaffected by the anti-Rh serum. Destruction of the Rh+ red cells or the coating of their antigenic sites by antibody blocks maternal sensitization. The antibody must be administered after delivery or termination of all subsequent pregnancies in order to prevent isoimmunization. 

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