Erythroblastosis Fetalis

Erythroblastosis Fetal

Introduction

Haemolytic disease was first describe in 1609 by a French nurse in newborn twins. One baby was abortive with hydrops fetalis and the second had a severe jaundice and died of what we today called kernicterus. These two states were again brought into conjunction in 1932, as Diamond et al. showed that hemolysis of red blood cells in the fetus to extramedullary erythropoiesis with subsequent hepatosplenomegaly . This results in bloodstream flood with erythroblasts, which is a condition called Erythoblastosis fetalis.

Discussion

Erythroblastosis fetalis, also called hemolytic disease in the newborn (HDN) is a blood disorder in which a mother produces antibodies during pregnancy that attack red blood cells of their own fetus when the mother and baby have blood types Rh different . In this case the mother was Rh negative and Rh + fetus, inherited from the father.

This can cause serious problems if fetal red blood cells come into contact with the blood of the mother. Although this is not a common occurrence during a normal pregnancy except during labor when the placenta detaches and baby's blood in contact with maternal blood. The blood contact also occurs during an abortion, whether spontaneous or provoked, or during an invasive prenatal testing procedure (eg, amniocentesis) (Smith, 1995).

Rh incompatibility affects 5% of couples. 10% of Rh negative mothers are sensitized after her first pregnancy, 30% do so after the second pregnancy, and 50% after the third. The risk of post-abortion awareness is 2%, and after an abortion is 4 to 5%. The reason for this problem is that the mother's immune system sees the baby's Rh positive red blood cells as "foreign" and worthy of being attacked by the maternal immune system, which responds by developing antibodies to fight the baby's red blood cells. Once it has developed the attack against the Rh positive the mother's immune system keeps the antibodies indefinitely if these foreign cells appear again in contact with maternal blood, and this produces the "Rh sensitization" of the mother . During the first pregnancy is unlikely that Rh sensitization. In the newborn, the condition is called hemolytic disease of the newborn.

Most worrying is that the mother's antibodies attack and destroy fetal red blood cells (hemolysis), and this results in the baby anemic and consequently the baby's body tries to produce more red blood cells more quickly, to compensate for the deficiency caused by hemolysis immune, this makes your organs to get bigger, being detrimental to their development. The new blood cells called erythroblasts not only cease to be precursors of erythrocytes, usually are immature and unable to fulfill the function of mature red blood cells. In addition, as red blood cells are destroyed, forming a substance called bilirubin that is difficult to get rid of her fetuses. Bilirubin may accumulate in your blood, tissues and body fluids, condition called hyperbilirubinemia on the skin and tissues of the baby turning yellow (Pearn J., 1994).

Types

The most common form of erythroblastosis fetalis is Rh incompatibility ...