新生儿疾病-Neonatal Jaundice lwz英文最终篇.pptVIP

* * * * * * * * * * * Hemolytic Disease of the Newborn Li weizhong Introduction Hemolytic disease of the newborn It is an isoimmunity hemolysis associated with ABO or Rh incompatibility. It results from transplacental passage of maternal antiboddy active against RBC antigens of the infant, leading to an increased rate of RBC destruction. It is an important cause of anemia and jaundice in newborn infant. Etiology and Pathogenesis ABO hemolytic disease ABO incompatibility Type O mothers Type A or B fetuses Presence of IgG anti-A or Anti-B antibodies in type O mother Frequently occurring during the first pregnancy without prior sensitization Etiology and Pathogenesis Rh hemolytic disease Rh blood group antigens (C, c, D, d, E, e) DECce Pathophysiology of alloimmune hemolysis resulting from Rh incompatibility An Rh-negative mother An Rh-positive fetus Leakage of fetal RBC into maternal circulation Maternal sensitization to D antigen on fetal RBC Etiology and Pathogenesis Production and transplacental passage of maternal anti-D antibodies into fetal circulation Attachment of maternal antibodies to Rh-positive fetal RBC Destruction of antibody-coated fetal RBC Etiology and Pathogenesis Rh hemolytic disease was rare during the first pregnancy involving an Rh-positive fetus. Once sensitization has occurred, re-exposure to Rh D RBC in subsequent pregnancies leads to an anamnestic response, with an increase in the maternal anti-Rh D antibody titer. The likelihood of an infant being affected increased significantly with each subsequent pregnancy. Clinical Manifestations Clinical Features Of Hemolytic Disease Laboratory Diagnosis Laboratory Features Of Hemolytic Disease Diagnosis The definitive diagnosis requires demonstration of blood group incompatibility and of corresponding antibody bound to the infant’s RBC. Diagnosis Antenatal Diagnosis History Expectant parents’ blood types Maternal titer of IgG antibodies to D or E (1:32) At 12～