Haemolytic disease of the fetus and newborn

Haas, Masja de; Thurik, Florentine F.; Koelewijn, Joke M.; Schoot, C. Ellen van der

doi:10.1111/vox.12265

Cited by 207 publications

(219 citation statements)

References 110 publications

(160 reference statements)

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“…Hemolytic disease of the fetus and newborn (HDFN) is a condition in which fetal and neonatal erythroid cells are destroyed by maternal erythrocyte IgG alloantibodies that are transported across the placenta [1,2]. Maternal alloimmunization can be triggered by more than 50 different erythrocyte antigens, but most severe cases involve the Rhesus-D antigen (RhD), which causes Rhesus-mediated hemolytic disease [3].…”

Section: Introductionmentioning

confidence: 99%

Neonatal management and outcome in alloimmune hemolytic disease

Ree

Smits-Wintjens

Bom

et al. 2017

Expert Review of Hematology

103

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Introduction: Hemolytic disease of the fetus and newborn (HDFN) occurs when fetal and neonatal erythroid cells are destroyed by maternal erythrocyte alloantibodies, it leads to anemia and hydrops in the fetus, and hyperbilirubinemia and kernicterus in the newborn. Postnatal care consists of intensive phototherapy and exchange transfusions to treat severe hyperbilirubinemia and top-up transfusions to treat early and late anemia. Other postnatal complications have been reported such as thrombocytopenia, iron overload and cholestasis requiring specific management. Areas covered: This review focusses on the current neonatal management and outcome of hemolytic disease and discusses postnatal treatment options as well as literature on long-term neurodevelopmental outcome. Expert commentary: Despite major advances in neonatal management, multiple issues have to be addressed to optimize postnatal management and completely eradicate kernicterus. Except for strict adherence to guidelines, improvement could be achieved by clarifying the epidemiology and pathophysiology of HDFN. Several pharmacotherapeutic agents should be further researched as alternative treatment options in hyperbilirubinemia, including immunoglobulins, albumin, phenobarbital, metalloporphyrins, zinc, clofibrate and prebiotics. Larger trials are warranted to evaluate EPO, folate and vitamin E in neonates. Long-term follow-up studies are needed in HDFN, especially on thrombocytopenia, iron overload and cholestasis.ARTICLE HISTORY

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Section: Introductionmentioning

confidence: 99%

Neonatal management and outcome in alloimmune hemolytic disease

Ree

Smits-Wintjens

Bom

et al. 2017

Expert Review of Hematology

103

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“…Such women should attend pre-pregnancy counseling with a clinician who has knowledge and expertise in managing these conditions. 7 Obstetricians managing these patients should be aware that severe fetal anemia can result in hydrops which worsens the perinatal outcome. Non-invasive fetal genotyping using maternal blood is now possible for D, C, c, E, e and K antigens.…”

Section: • Abo Hdfn It Caused By Anti-a B In a Group O Woman Or By mentioning

confidence: 99%

Successful management of an Rh alloimmunised twin gestation pregnancy with multiple atypical antibodies with severe fetal anemia

Sikarwar¹,

Satia²,

Panchbudhe³

2017

Int J Reprod Contracept Obstet Gynecol

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Rhesus-D alloimmunization is characterized by production of antibodies as a result of immune response generated in an individual due to exposure to alloantibodies from different individual. Here we are reporting a case of successful obstetric and perinatal outcome of twin pregnancy with Rh-incompatibility along with other atypical antibodies leading to fetal and neonatal anemia in both the twins. Antenatal management consisted of serial obstetric Doppler to look for Middle cerebral artery blood flow and Peak systolic velocity to detect fetal anemia followed by Intra Uterine transfusion of packed red cells through umbilical vein to treat the same for both the twins. In the presence of multiple atypical antibodies in the maternal serum no compatible blood was available for transfusion for either the mother or the neonates after delivery so NICU management consisted initially of transfusion of intravenous immunoglobulin’s along with steroids to prevent auto and alloantibody reactions but in view of dropping hemoglobin in both twins least incompatible blood was given to both the twins.

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“…11 Non-ABO-related HTRs are the cause of 15% of transfusion-associated deaths in the United States, 12 and nationally the risks of non-ABO HTR are reported to be 1 per 124,525 components transfused. The risk of DHTRs is even more common, at 1 per 20,569 component transfused, 12 with high suspicion that these adverse events are under-recognized and underreported.…”

Section: Clinical Significance Of Blood Types: Allosensitizationmentioning

confidence: 99%

Using red blood cell genomics in transfusion medicine

Johnsen

2015

Hematology

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Blood types (blood group antigens) are heritable polymorphic antigenic molecules on the surface of blood cells. These were amongst the first human Mendelian traits identified, and the genetic basis of nearly all of the hundreds of blood types is known. Clinical laboratory methods have proven useful to identify selected blood group gene variants, and use of genetic blood type information is becoming widespread. However, the breadth and complexity of clinically relevant blood group genetic variation poses challenges. With recent advances in next-generation sequencing technologies, a more comprehensive DNA sequence-based genetic blood typing approach is now feasible. This chapter introduces the practitioner to high-resolution genetic blood typing beginning with an overview of the genetics of blood group antigens, the clinical problem of allosensitization, current blood type testing methods, and then discussion of next-generation sequencing and its application to the problem of genetic blood typing. Learning Objectives• To understand the different types of genetic variation • To introduce principles of the nomenclature used to describe DNA variants • To understand the strengths and limitations in assigning blood types using genetic information

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Haemolytic disease of the fetus and newborn

Cited by 207 publications

References 110 publications

Neonatal management and outcome in alloimmune hemolytic disease

Neonatal management and outcome in alloimmune hemolytic disease

Successful management of an Rh alloimmunised twin gestation pregnancy with multiple atypical antibodies with severe fetal anemia

Using red blood cell genomics in transfusion medicine

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