Rhesus disease/haemolytic disease of the newborn Flashcards
What is rhesus disease of the newborn?
It is when the mother produces antibodies which cross the placenta and destroy the babies blood - producing a jaundiced baby with anaemia.
What is the only combination which can cause haemolytic disease?
A rhesus negative mother with a rhesus positive baby.
What is rhesus positive?
When your blood has the rhesus protein/antigen on it
It is more common to be rhesus positive than it is to be rhesus negative.
What is rhesus negative?
When your blood cells don’t have the rhesus protein/antigen on them
This is less common than rhesus negative
It shouldn’t affect your health (but might cause problems if you have a rhesus positive baby)
What happens when a rhesus negative mother comes into contact with rhesus positive blood?
She will produce antibodies, these are small enough to be transferred across the placental membrane.
They will attack the babies blood.
What is the antibody called that’s made by the rhesus negative mother?
Anti-D antibody.
What are the consequences to the baby of rhesus disease?
Jaundice (too much bilirubin caused by the breakdown of red blood cells) Anaemia Short RBC life cycle Hydrops fetalis (Often incompatible with life) Pallor (pale skin) Hepatosplenomegaly Oedema Petechiae Ascites Still born Deafness Blindness
What are the consequences to the baby of rhesus disease?
Jaundice (too much bilirubin caused by the breakdown of red blood cells) Haemolytic Anaemia Brain damage (learning difficulties) Short RBC life cycle Hydrops fetalis (Often incompatible with life) Pallor (pale skin) Hepatosplenomegaly Oedema Petechiae Ascites
When does haemolytic disease occur?
Often the first baby is fine as it is delivered soon after bloods cross BUT if the mother has another rhesus positive baby, the Anti-D antibodies will already be there so it will affect them more.
What is the prevention for haemolytic disease of the newborn?
Anti-D immunoglobulin injection.
This removes the babies blood before the mother has an immune response to them.
This does NOT help mothers who have already created ANTI-D antibodies.
Who is prevention given to?
ALL Rhesus negative mothers - if the mother is rhesus negative, you should assume the baby is positive.
What treatment is given if the mother becomes pregnant and has previously already developed Anti-D antibodies?
The pregnancy will be monitored more closely and the baby will be monitored closely after delivery.
What is the treatment for haemolytic disease of the newborn?
Blood transfusion to baby - if needed.
Light treatment - phototherapy.
Anti-D immunoglobulin injection.
When is the mother likely to be exposed to foetal blood?
During delivery
If there has been bleeding during pregnancy
After invasive tests - amniosentesis, chorionic villi sampling
Trauma to mothers abdomen
Late miscarriage > 12 weeks
When is Anti-D immunoglobulin given routinely?
At 28 weeks.
