Hemolysis due to incompatibility of blood groups

Hemolysis due to incompatibility of blood groups is defined as the disease where the newborn's red blood cells are destroyed because maternal antibodies against the child's red blood cells circulate in the baby's bloodstream.

This disease is suspected when jaundice appears in the baby in the first 24 hours of life.

Causes

• ABO incompatibility: it is the most frequent group incompatibility. It is a reaction of the immune system that occurs if two incompatible blood groups come into contact. The main blood groups are A, B and O and are differentiated by the presence of molecules that are on the surface of blood cells. It is these molecules that are recognized as foreign if different blood groups come into contact. In the event that a pregnant woman has group O, she may have anti-A and anti-B antibodies. If the fetus has a group A, B or AB, the mother's antibodies pass to the baby through the placenta and cause the destruction of her red blood cells. It can occur in the first pregnancy. Symptoms are mild and cause increased bilirubin and jaundice in the newborn. Some babies do not require treatment; in the most difficult cases the treatment is phototherapy.
• Rh incompatibility: is a condition that occurs when the pregnant woman has Rh negative blood and the fetus has Rh positive blood (the father must be Rh positive). During pregnancy, red blood cells from the fetus can pass into the mother's bloodstream through the placenta; the mother's immune system recognizes the fetus's red blood cells as foreign and creates antibodies (anti-Rh positive) against them, which can cross the placenta, reach the fetus, and destroy the baby's red blood cells (hemolysis). If the mother has not had previous pregnancies or abortions, the baby is not affected (the mother does not have time, in the first pregnancy, to generate the antibodies). Rh incompatibility arises from the second pregnancy, causing intense hemolysis. When the baby is born, the affectation can be mild or very serious: hypotonia, jaundice, mental retardation, hydrops fetalis and anemia. To prevent this situation, the Rh negative mother is treated during pregnancy by injecting her with special immunoglobulins that prevent the formation of anti-Rh positive antibodies.

Treatment

Treatment of group incompatibility is based on:

• -Hydrate the baby correctly
• -Phototherapy (exposing the newborn to a spot of ultraviolet light to help eliminate excess bilirubin)

In mild cases, recovery is complete and without sequelae.