m Afflicts newborns whose mothers are blood type is

O, and who have a baby with type A, B, or AB.

m In type O mothers, isoantibody is IgG and is
capable of crossing the placental membranes
m Transplacental transport of maternal isoantibody
results in an immune reaction with the A or B
antigen on fetal erythrocytes causing hemolysis
m 6



 
d Of the major blood group antigens, the A1 antigen has
the greatest risk of symptomatic disease
m À 

 

d Antepartum intestinal parasitism or third-trimester
immunization with tetanus toxoid or pneumococcal
vaccine may stimulate isoantibody titer to A or B
antigens.
m B


 
 


 


   

 
and is
independent of prior exposure to incompatible
fetal blood group antigens. First-born infants have
a 40-50% risk for symptomatic disease.
Progressive severity of the hemolytic process in
succeeding pregnancies is a rare phenomenon.
m Maundice
d onset is usually within the first 24 h of life
m Anemia
m B 


  


 



 
m 

 

m 
 


 
 
d Because there is very little antibody on the red blood cell
(RBC), the direct Coomb's test is often only weakly
positive at birth and may become negative by 2-3 days of
age.
m B 

d microspherocytes, polychromasia proportionate to the
reticulocyte response, and normoblastosis above the
normal values for gestational age.
m 
 

m Phototherapy
m Exchange transfusion
m IVIG
d By blocking neonatal reticuloendothelial Fc receptors,
and thus decrease hemolysis of the antibody-coated
RBCs, high-dose IVIG (1 g/kg over 4h) has been shown
to reduce serum bilirubin levels and the need for blood
exchange transfusion with ABO or Rh hemolytic
diseases.
 BABY BLOOD TYPE A
(weak expression of Antigen A)

ABO incompatibility: Transfer of Anti-A

and Anti-B from the Mother who is
Blood Type O

Baby now has Anti-A and Anti-B

HEMOLYSIS
 Ñhat type of Blood to transfuse
in anemic patients with ABO
incompatibility?

Transfuse Adult Blood that is Blood

Type A Transfuse Blood Type O
(contains strong expression of Antigen (contains Anti-A and Anti-B)
A) (does not contain antigens)

Since Baby has Anti-A and Anti-B

RESULT: No further hemolysis
in ABO incompatiblity
of the transfused blood

RESULT: HEMOLYSIS of the

transfused blood