Hemolytic disease of the fetus
Once in the bloodstream of the fetus, Rh immune antibodiesreact with its Rh-positive red blood cells (reaction "antigen - antibody"), whereby there is a destruction (hemolysis) of red blood cells and develop hemolytic disease of the fetus (HDN). The destruction of red blood cells leads to anemia (decrease in amount of hemoglobin) in the fetus, as well as damage to his kidneys and brain. Since red blood cells are constantly being destroyed, the liver and spleen of the fetus are trying to speed up the production of new red blood cells, while increasing in size.
The main manifestations of hemolytic diseasefetus are an enlarged liver and spleen, increase in the amount of amniotic fluid, a thickening of the placenta. All these signs are detected by ultrasound during pregnancy.
In the most severe cases, when the liver and spleencan not cope with the load, there comes a strong lack of oxygen, hemolytic disease leads to fetal death at various stages of pregnancy. Most often, Rhesus-conflict appears after the birth of a child, helped by arrival of large amounts of antibody in the blood of a baby in violation of the integrity of the blood vessels of the placenta. Hemolytic disease manifested anemia and jaundice of the newborn.
Depending on the severity of hemolytic disease are several of its forms.
Anemic form of this most benigncurrent version of hemolytic disease of the newborn. Manifested immediately after birth or during the 1st week of life from anemia, which is associated with pale skin. Increased liver and spleen size, there is little change in the results of analyzes. Overall condition of the baby is disturbed enough, the outcome of this current favorable disease.
Icteric form is the most common mediumsevere form of hemolytic disease of the newborn. Its main manifestations are early jaundice, anemia, enlarged liver and spleen. Condition worsens the baby with the accumulation of the product breakdown of hemoglobin - bilirubin: crumb becomes sluggish, drowsy, he oppressed the physiological reflexes, decreased muscle tone. On 3 - 4 th day of untreated bilirubin can reach critical numbers, and then perhaps the appearance of symptoms of kernicterus: stiff neck, when the baby may not tilt your head forward (attempts to bring the chin to the chest are unsuccessful, they are accompanied by tears), cramps, wide-open eyes, a piercing scream. By the end of the 1st week can develop bile stasis syndrome: skin becomes greenish, discolored feces, urine darkens, the content of conjugated bilirubin in the blood increases. Icteric HDN accompanied by anemia.
Edematous form - the worst variant of thedisease. If miscarriage may occur early development of immunological conflict. With the progression of the disease a massive intrauterine hemolysis - the disintegration of red blood cells - leading to severe anemia, hypoxia (oxygen deficiency), disorders of metabolism, reduce the level of proteins in the bloodstream and tissue edema. The fruit is born in critical condition. Swollen tissues in the body cavities (thoracic, abdominal) fluid accumulates. Leather sharply pale, glossy, jaundice is weak. Such infants are sluggish, the muscle tone they have sharply reduced, depressed reflexes.
The liver and spleen were significantly increased, a large belly. It expressed cardiopulmonary insufficiency.