Medicine an Surgery notes

Apr 25th, 2015
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HEMOLYTIC DISEASE OF THE NEWBORN (ERYTHROBLASTOSIS FETALIS)In 1932, Diamond and co-workers suggested that three clinical syndromes, anemia of the newborn, universal edema of the fetus (hydrops fetalis), and icterus gravis neonatorum, were all part of the spectrum of a single disease.They named the disease erythroblastosis fetalis because of the high concentration of erythroblasts in the peripheral blood of the affected infant at birth.MATERNAL SENSITIZATIONMaternal sensitization to the D antigen in the Rh system has caused most of the significant disease.There are three sets of allelic antigens in the Rh system: C and c, E and e, and D and absence of D (no allelic "d" antigen has been identified). A person can be homozygous or heterozygous for each set of alleles (e.g. CC, Cc, or cc).The commonly used terms "Rh positive" and "Rh negative" are confusing because they only refer to the presence or absence of the D antigen. A woman who is D-negative can become sensitized during a pregnancy with a D-positive fetus when fetal erythrocytes cross the placenta in the second and third trimester and during delivery. Usually antibodies appear in the mother within the first 6 months after the sensitizing pregnancy, but occasionally they appear during the first pregnancyIf the father is homozygous for the D antigen, all fetuses will be heterozygous and capable of sensitizing the mother. Sensitization, however, does not occur in every potential case. If the father is heterozy

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