Among the Han population in China, the incidence of neonatal hemolysis caused by ABO blood group incompatibility is the highest, with more than 90% occurring in pregnant mothers.
Type o blood, the husband is type a, b or AB blood.
Neonatal hemolytic disease, also known as "maternal-child blood group incompatibility hemolytic disease", refers to the phenomenon that the blood type of the baby inherits the blood type of the father due to the different blood types of the husband and wife, which eventually leads to the hemolysis of the baby and newborn.
How does hemolysis happen?
Under normal circumstances, there is a natural barrier between pregnant mommy and fetal baby, that is placenta. This barrier can protect most blood components between pregnant mommy and baby from direct contact. However, there will still be a small amount of fetal baby's blood components infiltrating into pregnant mommy's blood through the placenta; At the same time, the blood components of pregnant mommy will also enter the baby in a small amount, and the incompatibility of these two components will lead to hemolysis of the baby. Usually, the degree of hemolysis is relatively mild in most cases where the blood types of mother and baby are incompatible, but after the baby is born, the blood components from pregnant mommy will be slowly metabolized, which will take a while and the baby will soon return to normal. Therefore, pregnant mothers with type O blood can get pregnant and have children as usual.
Only in rare cases, when a large number of blood components incompatible with the pregnant mother and the fetus enter the fetus through the placenta, will it lead to serious neonatal hemolysis.
ABO hemolysis mostly occurs when pregnant mommy is pregnant with the second child, but 40% ~ 50% of ABO hemolysis also occurs in the first child, so pregnant mommy with O blood should cherish the first child.
Neonatal jaundice is different from hemolysis.
Neonatal hemolytic symptoms vary from mild to severe. Under normal circumstances, the baby will have a certain degree of jaundice from the second day after birth, and mommy will find that the baby's head, face or chest and abdomen will have the same color as lemon yellow; On the 4th to 6th day, the degree of jaundice deepened. After birth 10 days, it gradually subsided and returned to normal.
If the skin jaundice develops rapidly within 24 hours to 3 days after birth, even to the whole body, and the color changes from light yellow to dark yellow, we should be alert to neonatal hemolysis.
harm
Massive hemolysis can cause severe anemia and even heart failure;
Severe anemia, hypoproteinemia and heart failure of fetal baby can cause systemic edema; Anemia can also cause compensatory hyperplasia of extramedullary hematopoietic tissue and hepatosplenomegaly;
A large amount of unconjugated bilirubin produced by hemolysis crosses the blood-brain barrier, making the brain nucleus yellow, causing sequelae such as visual impairment, deafness, tooth dysplasia, mental retardation and epilepsy. , which is bilirubin encephalopathy, but generally ABO hemolysis will not have such serious consequences.
prevent
There is no fundamental way to prevent maternal-infant blood group incompatibility because of the inability to control the selection of genetic material of the baby's blood group, but we can intervene through pre-pregnancy and prenatal examination and treatment to prevent the occurrence of severe hemolysis of the newborn. In addition, cherishing the first child and avoiding multiple blood transfusions is also an important part of preventing neonatal hemolysis.
1. Pre-pregnancy examination
Both husband and wife went to the hospital to check their blood types. Couples with ABO blood group incompatibility should measure the antibody and its titer in pregnant mommy's blood. Only the titer ≥ 1: 64 is meaningful, suggesting that ABO hemolysis may occur after pregnancy.
2. Prenatal check-up
Pregnant mothers with a history of blood transfusion, abortion and severe jaundice should have their blood types and blood group antibodies checked before delivery, and the antibodies in blood should be tested regularly from about 16 weeks: generally 4 weeks 1 time; 1 28 ~ 32 weeks of pregnancy should be measured every 2 weeks; After 32 weeks of pregnancy, test 1 time every week.
If the titer increases significantly after continuous examination, it often indicates that the baby has been affected.
If the titer drops significantly in the third trimester, it means that the baby has hemolysis. At this time, amniotic fluid examination and ultrasonic examination should be used to estimate the degree of hemolysis and edema of the baby.
3. Prenatal treatment
If fetal hemolysis is diagnosed, it can be treated by plasma exchange of pregnant mommy and early delivery. Early diagnosis and treatment can effectively prevent the occurrence of neonatal hemolysis.