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ABO Incompatibility Disease of The Newborn
ABO Incompatibility Disease of The Newborn
ABO Incompatibility Disease of The Newborn
In type O mothers, isoantibody is IgG and is capable of crossing the placental membranes Transplacental transport of maternal isoantibody results in an immune reaction with the A or B antigen on fetal erythrocytes causing hemolysis
Elevated isohemagglutinins
Antepartum intestinal parasitism or third-trimester immunization with tetanus toxoid or pneumococcal vaccine may stimulate isoantibody titer to A or B antigens.
Birth order is not considered a risk factor. Maternal isoantibody exists naturally 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.
Jaundice
onset is usually within the first 24 h of life
Anemia
Blood type and Rh factor in the mother and the infant Increased reticulocyte count Direct Coombs' test (direct antiglobulin test)
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.
Blood smear
microspherocytes, polychromasia proportionate to the reticulocyte response, and normoblastosis above the normal values for gestational age.
Indirect hyperbilirubinemia
ABO incompatibility: Transfer of Anti-A and Anti-B from the Mother who is Blood Type O
HEMOLYSIS
Transfuse Blood Type O (contains Anti-A and Anti-B) (does not contain antigens)