Hemolytic disease of the newborn (HDN) due to ABO and Rh incompatibility is the most common cause of fetal loss and death in the babies. ABO blood group and Rh factor incompatibility causing hemolytic disease of the newborn needs complete workup and assessment by Best Gynecologist in Islamabad.

Read on to know more about this: 

What is hemolytic disease of the newborn (HDN)?

As the name implies, the hemolysis or breakdown of red blood cell disease of the newborn occurs because the ABO blood group or Rh factor of the mother and the baby are incompatible. In the body, the blood cells have any of the A, B, AB or O blood groups, along with an Rh factor (positive or negative). When the mother and the baby have different blood groups or Rh factors, there is a problem. 

HDN occurs when the mother with an Rh negative blood group, conceives a baby with an Rh positive factor. Consequently, at the time of birth or in case of a miscarriage, these Rh-positive red blood cells of the baby go into the mother’s bloodstream and produce anti Rh-positive antibodies. This can also occur during chorionic villus sampling and amniocentesis. The anti-Rh-positive antibodies are stored in the immune system of the mother and attack the future pregnancies. This is known as Rh sensitization. 

HDN in subsequent pregnancies

Rh sensitization is not a problem in the first pregnancy, but in the subsequent pregnancies there is a problem. During the pregnancy, if the baby is Rh-positive, the anti-Rh-antibodies from the mother (formed during the previous pregnancy) travel through the placenta to the baby and attack the red blood cells. As these antibodies destroy the red blood cells, there is hemolysis and the baby gets sick. 

HDN due to ABO incompatibility

Hemolysis also occurs if the blood groups of the mother and the baby are different and the mother is carrying antibodies against the baby’s blood group. It arises when a mother with type O blood group becomes pregnant with a baby with type A, B or AB blood group. The antibodies naturally present in the mother then cross the placenta and hemolyze or breakdown the red blood cells of the fetus. The severity of hemolysis in ABO blood groups is less severe than Rh incompatibility. 

How is ABO incompatibility and hemolytic disease of the newborn diagnosed?

The diagnosis of hemolytic disease of newborn is made through the following investigations before the birth of the baby:

Blood tests: the blood is tested to look for anti-Rh-positive antibodies in the blood of the mother. 

Percutaneous umbilical cord blood sampling: this is the fetal blood sampling. Blood is taken from the umbilical cord of the baby to check for antibodies. This is done to check if the baby needs intrauterine blood transfusion. 

Amniocentesis: the amniotic fluid is removed through a needle and the amount of bilirubin is check in it. Bilirubin is produced in response to the breakdown of fetal RBCs.  

Ultra sound: in HDN, the organs of the baby are enlarged secondary to hemolysis. An ultrasound helps to detect the enlarged organs and fluid buildup. 

After the birth:

Umbilical cord blood testing: following birth, this shows the blood group of the baby, the red cell count, the antibodies and the Rh factor. 

Serum bilirubin: the baby’s blood is tested for bilirubin levels. 

How is ABO incompatibility and hemolytic disease of the newborn treated?

During pregnancy, babies suspected of HDN are monitored by Best Gynecologist in Lahore throughout the pregnancy. Fetal doppler ultrasound helps to check the blood flow to the baby and in case of increased hemolysis intrauterine blood transfusion is done.