ABO Incompatibility
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Transcript of ABO Incompatibility
By:Marvi Mae Jimena
Rosean Marvi Joy M. Yunsay
ABO INCOMPATIBILITY
ABO blood group
ABO Incompatibility
ABO incompatibility is common and generally mild
type of hemolytic disease in babies
In most cases of ABO incompatibility, the maternal
blood type is O and the fetal blood type is A.
It may also occur when the fetus has type B or AB
blood.
The reticulocyte count (immature of newly formed
red blood cells) is usually elevated as an infant
attempts to replace destroyed cells.
Pathophysiology
Etiology:Unkown
Predisposing and precipitating factors :
MiscarriageTraumaBirth(especially during placental
separation)
Mixing of maternal and fetal blood
Antibodies against foreign blood type is formed
Antibodies circulate through the fetal circulation
Hemolysis of the baby’s blood cells
Pathophysiology
• ABO antibodies are of large (IgM) class and do not
cross the placenta.
• Hemolysis of blood begins AT BIRTH, when the
blood and antibodies are exchanged during the
mixing of maternal and fetal as the placenta is
loosened
• destruction of red blood cells may continue for up
to 2 weeks of age.
AN INFANT OF AN ABO INCOMPATIBILITY IS NOT BORN ANEMIC AS IS THE Rh SENSITISED CHILD.
WHY?
This may be because the receptor sites for anti-A or anti-B antibodies do not appear on red cells until late in fetal life. Even in the mature newborn, the direct Coomb’s test may be only weakly positive because of the few anti-A or anti-B sites present.
PRETERM INFANTS DO NOT SEEM TO BE AFFECTED.
WHY?
Progressive jaundice within the first 24 hours of life. Jaundice occurs because as red blood cells are destroyed, indirect bilirubin (fat-soluble and cannot be excreted from the body) is released.
Brain damage and Kernicterus can occur
Assessment
Progressive hypoglycemia. An infant needs to use glucose stores to maintain metabolism in the presence of anemia.
Decrese in HgbTachypneaDyspneaTachycardia
Assessment
Exchange Transfusion The procedure involves alternatively
withdrawing small amounts (2-10 ml) of infant’s blood and then replacing it with equal amounts of donor blood via umbilical vein catheter
Procedure lasts 2-3 hoursremoves approximately 85% of sensitized
red cells in ABO incompatibility.
Management
Initiation of early feeding
Bilirubin is removed from the body by being incorporated into feces. Therefore, the sooner the bowel elimination begins, the sooner bilirubin removal begins.
Management
Phototherapy
Exposure to light triggers the liver to assume its function which is to process bilirubin.
Additional light supplied by phototherapy speed the conversion potential of the liver.
Management
Infant’s eyes must be covered under
bilirubin lights because the retina can be
damaged.
Infants should also wear a gonadal shield
Stools are often bright green because of
excessive bilirubin. They are also loose and
frequently irritating to the skin.
POINTS TO REMEMBER during PHOTOTHERAPY
Urobilinogen formation may cause dark-
colored urine.
Monitor temperature.
Explain importance to parents.
Turn the infant every two hours to expose
different parts of the infants body
Monitor I&O.