After the birth of Martha’s second child, she was informed that her newborn had

Question

After the birth of Martha’s second child, she was informed that her newborn had jaundice. The doctor suspects Hemolytic Disease of the Newborn (HDN). What is jaundice and how could the baby have developed it? Describe both HDN and ABO hemolytic disease of the newborn i.e. what causes them to occur and how do they present? Explain TWO differences and TWO similarities between the two diseases and then, discuss prevention and treatments available for the two diseases.

Reminder: Show critical thinking. Support your opinions with scientific evidence (in initial response and response to your classmates). Provide citations for the information you discuss.

Explanation / Answer

Hemolytic disease of the new born is a life-threatening condition in the newborn in which the RBC are destroyed earlier than the normal. The condition occurs when the baby’s RBC is sensed as foreign by the mother’s immune system. The mother’s immune system produces antibodies against the baby’s blood and makes them lose.

The condition arises when the mother and the baby have different blood groups. The condition may arise either due to ABO incompatibility or Rh incompatibility. While ABO incompatibility is not very severe, the RN incompatibility between the mother and the baby causes severe hemolytic anemia in the baby.

The most common incompatibility is that when the mother is Rh negative and the baby is Rh positive. During delivery, some of the RBC of the first baby comes in contact with the mother’s immune system and the system develops antibodies against Rh antigens. During subsequent pregnancies, if the baby is Rh positive, the mother’s immune system recognizes it as foreign and lose them.

To cope up with the lysis, the baby’s hemopoietic system tries to produce more RBC, releasing premature cells into circulation. The more the cells are produced, the more is the lysis of the cells and this leads to jaundice.

Jaundice occurs in this case due to excessive hemolysis. The pigments derived from hemoglobin when RBC are lysed is metabolized in the liver to form bilirubin. Bilirubin is normally secreted in the bile. If the destruction of erythrocytes is excessive, bilirubin accumulates in the blood, under the skin, and in body fluids. Jaundice is not a disease, it is a disease symptom.

While ABO hemolytic disease occurs due to mismatch of blood group between mother and the fetus, the hemolytic disease occurs due to mismatch of Rh factor. ABO hemolysis is less severe, results in mild jaundice only, whereas HDN may be fatal.

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