ACQUIRED HAEMOLYTIC ANAEMIAS
-1-Immune Haemolytic Anaemias
Haemolytic Disease of the newborn :
Q Resulting from the transplacental transfer of
maternal blood group antibodies capable of destroying the infant’s red cells .
Q Interaction of maternal antibodies with
incompatible erythrocytes causes haemolysis .
Q Severely affected fetuses may develop the
full- blown picture of hydrops fetalis with anaemia , jaundice ,
hepatosplenomegaly and oedema .
Q Unconjugated bilirubin formed from breakdown
of haemoglobin , crosses the placenta ; after birth , leading to the condition
of kernicterus .
Pathogenesis
The condition usually results from the passage
of antibodies of the rhesus or ABO blood group system . Rhesus isoimmune
disease affects Rh positive featuses of Rh negative mothers , may also results
from transfusion of Rh positive blood .
Prevention
Prevention
It is possible to prevent sensitization of a Rh negative mother by administering anti –
D (Rh) immunoglobin immediately after delivery of an Rh positive baby , or
after abortion , and anti- partum
haemorrhage or other traumatic events during pregnancy .
Treatment :
At birth , cord blood should be taken for
estimation of haemoglobin (Hb ) and bilirubin levels , bilirubin 75 mmol /litre
indicates the need for exchange transfusions may , be required if the bilirubin
levels does not fall to a safe level .
Phototherapy is an effective way of reducing
hyperbilirubinaemia associated with hemolysis in this condition .
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