ArtsAutosBooksBusinessEducationEntertainmentFamilyFashionFoodGamesGenderHealthHolidaysHomeHubPagesPersonal FinancePetsPoliticsReligionSportsTechnologyTravel

Pathogenesis And Clinical Presentation Of Hemolytic Disease Of The New Born

Updated on January 19, 2014

Phototherapy On A New Born


Jaundiced Infant


Hemolytic Disease Of The New Born

The newborn may suffer from Rh incompatibility or ABO incompatibility if there is Rh or ABO incompatibility between the parents.

Rh incompatibility: This accounts for the vast majority of isoimmune hemolytic anemias of the newborn and manifests as jaundice on the first day of life. Among the Rh antigens ‘D’ is most antigenic and this is involved in Rh incompatibility. In India for instance, 8% of population is Rh negative, unlike in the west where the frequency is 15%. About 17% of Rh negative women get immunized during pregnancy if the fetus is Rh positive.


The Rh isoimmunisation occurs when an Rh negative individual receives Rh positive blood by transfusion or by other sources. When an Rh negative mother carries an Rh positive fetus, there is risk of transplacental entry of small quantities of fetal blood into the maternal circulation during the last weeks of pregnancy and during labour. Therapeutic obstetric procedures increase the risk. The fetal cells immuise the mother, and antibodies are produced depending upon the amount of transplacental hemorrhage. The ABO incompatibility between the mother and the baby protects against Rh immunization. Usually, the first born child escapes unless the mother is previously sensitized due to Rh incompatible blood transfusions during childhood or due to previous abortions. With successive pregnancies and abortion, the antibody titer in the mother progressively rises. The maternal antibodies pass back into the fetus and lead to hemolysis of fetal erythrocytes, resulting in hemolytic disease of the newborn. Severity of hemolysis depends upon the amount of maternal antibody and the period of gestation at which the fetus is affected.

The unconjugated bilirubin formedby hemolysis is bound to albumin, but when the bilirubin level exceeds 20 mg/dl, the unbound bilirubin passes to the CNS and causes damage, which is most pronounced in the basal ganglia.

Rhesus Imcompatibility


Clinical presentation

The mild form manifests as moderate hemolytic anemia in the first few days of life. Hepatosplenomegaly may be just detectable. The moderately severe form presents as ‘icterus gravis neonatorum’. This leads to jaundice. Anemiamay progress and lead to cardiac failure. Hepatosplenomegaly may be more evident. Neurological abnormalities develop in severe cases. In acute form, it is characterized by a high pitched cry, opisthotonus and convulsions. Choreoathetosis, deafness, cerebral palsy and mental deficiency develop as the child grows. The neurological complications are collectively known as Kernicterus.

The severe form manifests as hydrops fetalis. Usually, the affected baby is born dead or it dies soon after birth. Gross edema, hepatosplenomegaly, anemia and effusions into serous cavities are the common stigmata.

© 2014 Funom Theophilus Makama


    0 of 8192 characters used
    Post Comment

    No comments yet.


    This website uses cookies

    As a user in the EEA, your approval is needed on a few things. To provide a better website experience, uses cookies (and other similar technologies) and may collect, process, and share personal data. Please choose which areas of our service you consent to our doing so.

    For more information on managing or withdrawing consents and how we handle data, visit our Privacy Policy at:

    Show Details
    HubPages Device IDThis is used to identify particular browsers or devices when the access the service, and is used for security reasons.
    LoginThis is necessary to sign in to the HubPages Service.
    Google RecaptchaThis is used to prevent bots and spam. (Privacy Policy)
    AkismetThis is used to detect comment spam. (Privacy Policy)
    HubPages Google AnalyticsThis is used to provide data on traffic to our website, all personally identifyable data is anonymized. (Privacy Policy)
    HubPages Traffic PixelThis is used to collect data on traffic to articles and other pages on our site. Unless you are signed in to a HubPages account, all personally identifiable information is anonymized.
    Amazon Web ServicesThis is a cloud services platform that we used to host our service. (Privacy Policy)
    CloudflareThis is a cloud CDN service that we use to efficiently deliver files required for our service to operate such as javascript, cascading style sheets, images, and videos. (Privacy Policy)
    Google Hosted LibrariesJavascript software libraries such as jQuery are loaded at endpoints on the or domains, for performance and efficiency reasons. (Privacy Policy)
    Google Custom SearchThis is feature allows you to search the site. (Privacy Policy)
    Google MapsSome articles have Google Maps embedded in them. (Privacy Policy)
    Google ChartsThis is used to display charts and graphs on articles and the author center. (Privacy Policy)
    Google AdSense Host APIThis service allows you to sign up for or associate a Google AdSense account with HubPages, so that you can earn money from ads on your articles. No data is shared unless you engage with this feature. (Privacy Policy)
    Google YouTubeSome articles have YouTube videos embedded in them. (Privacy Policy)
    VimeoSome articles have Vimeo videos embedded in them. (Privacy Policy)
    PaypalThis is used for a registered author who enrolls in the HubPages Earnings program and requests to be paid via PayPal. No data is shared with Paypal unless you engage with this feature. (Privacy Policy)
    Facebook LoginYou can use this to streamline signing up for, or signing in to your Hubpages account. No data is shared with Facebook unless you engage with this feature. (Privacy Policy)
    MavenThis supports the Maven widget and search functionality. (Privacy Policy)
    Google AdSenseThis is an ad network. (Privacy Policy)
    Google DoubleClickGoogle provides ad serving technology and runs an ad network. (Privacy Policy)
    Index ExchangeThis is an ad network. (Privacy Policy)
    SovrnThis is an ad network. (Privacy Policy)
    Facebook AdsThis is an ad network. (Privacy Policy)
    Amazon Unified Ad MarketplaceThis is an ad network. (Privacy Policy)
    AppNexusThis is an ad network. (Privacy Policy)
    OpenxThis is an ad network. (Privacy Policy)
    Rubicon ProjectThis is an ad network. (Privacy Policy)
    TripleLiftThis is an ad network. (Privacy Policy)
    Say MediaWe partner with Say Media to deliver ad campaigns on our sites. (Privacy Policy)
    Remarketing PixelsWe may use remarketing pixels from advertising networks such as Google AdWords, Bing Ads, and Facebook in order to advertise the HubPages Service to people that have visited our sites.
    Conversion Tracking PixelsWe may use conversion tracking pixels from advertising networks such as Google AdWords, Bing Ads, and Facebook in order to identify when an advertisement has successfully resulted in the desired action, such as signing up for the HubPages Service or publishing an article on the HubPages Service.
    Author Google AnalyticsThis is used to provide traffic data and reports to the authors of articles on the HubPages Service. (Privacy Policy)
    ComscoreComScore is a media measurement and analytics company providing marketing data and analytics to enterprises, media and advertising agencies, and publishers. Non-consent will result in ComScore only processing obfuscated personal data. (Privacy Policy)
    Amazon Tracking PixelSome articles display amazon products as part of the Amazon Affiliate program, this pixel provides traffic statistics for those products (Privacy Policy)
    ClickscoThis is a data management platform studying reader behavior (Privacy Policy)