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(A.D.A.M., 2021)

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(A.D.A.M., 2021)

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McCance. (2019) photograph.

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A.D.A.M. (2022). photograph.

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A.D.A.M. (2021). Rh incompatibility [Photograph]. http://thnm.adam.com/content.aspx?productid=117&pid=1&gid=001600

Alila Medical Media. (2019). Hemolytic Disease of the Newborn, Animation [Video]. Youtube. https://www.youtube.com/watch?v=4hCzGhQPrzk

Boston Children's Hospital. (2022). Hemolytic disease. https://www.childrenshospital.org/conditions/hemolytic-disease

McCance, K. L., & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). Mosby Elsevier.

MedlinePlus. (2021). Hemolytic disease of the newborn. National Library of Medicine. https://medlineplus.gov/ency/article/001298.htm

Stanford Medicine Children's Health. (2021). Hemolytic disease of the newborn. https://www.stanfordchildrens.org/en/topic/default?id=hemolytic-disease-of-the-newborn-90-P02368

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Josephson CD, Sloan SR. Pediatric transfusion medicine. In: Hoffman R, Benz EJ, Silberstein LE, et al, eds. Hematology: Basic Principles and Practice. 7th ed. Philadelphia, PA: Elsevier; 2018:chap 121.

Niss O, Ware RE. Blood disorders. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 124.

Simmons PM, Magann EF. Immune and non-immune hydrops fetalis. In: Martin RJ, Fanaroff AA, Walsh MC, eds. Fanaroff and Martin's Neonatal-Perinatal Medicine: Diseases of the Fetus and Infant. 11th ed. Philadelphia, PA: Elsevier; 2020:chap 23.

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Hemolytic disease of the newborn: MedlinePlus Medical Encyclopedia

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Hemolytic disease of the newborn (HDN) is a blood disorder in a fetus or newborn infant. In some infants, it can be fatal.

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Rh negative mother conceives with an Rh positive father

ABO incompatability

More likely in the second child (Rh sensitization in mother)

(Boston Children's Hospital, 2022)

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Immunoprophylaxis: If you're Rh negative and have not been sensitized, you'll get a medicine called Rh immunoglobulin (RhoGAM). This medicine can stop your antibodies from reacting to your baby's Rh positive cells (Medlineplus, 2021).
Phototherapy:  Converts bilirubin into a form that is easier for the baby's body to get rid of (Medlineplus, 2021).
Intrauterine blood transfusions

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-Mild HDFN: Slightly pale, slight enlargement of the liver and spleen, neonatal jaundice
-Pallor, splenomegaly, and hepatomegaly indicate severe anemia--> CV failure and shock
-Kernicterus--> cerebral damage --> death
-Significant developmental delay, cerebral palsy, high-frequency deafness
(McCance & Huether, 2019)

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This is a disorder that causes a baby's RBC to break down quickly.  This occurs when the antigens on fetal erythrocytes differ from the antigens on maternal erythrocytes. Most cases of HDFN are caused by ABO incompatibility, and only one in three cases is caused by Rh incompatibility (McCance & Huether, 2019).

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Expected Therapeutic Management
(Think Drug Classes)

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Symptoms & Causes Diagnosis & Treatments

Programs & Services

Departments

Newborn Medicine

Department

Boston Children's Hospital - Division of Newborn Medicine

Centers

Cancer and Blood Disorders Center

Center

The Dana-Farber/Boston Children's Cancer and Blood Disorders Center is an integrated pediatric hematology and oncology program through Dana-Farber Cancer Institute and Boston Children's Hospital.

Programs

Blood Disorders Center

Program

Boston Children's Hospital - Blood Disorders Center

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Symptoms & Causes Diagnosis & Treatments Newborn Medicine Department Boston Children's Hospital - Division of Newborn Medicine Cancer and Blood Disorders Center Center The Dana-Farber/Boston Children's Cancer and Blood Disorders Center is an integrated pediatric hematology and oncology program through Dana-Farber Cancer Institute and Boston Children's Hospital.

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Tissue/Organ Level Pathophysiology
Hemolysis occurs when the mother's antibodies attack babies red blood cells. When this breakdown occurs, excess bilirubin forms, and it is hard for babies to get rid of bilirubin. Hyperbilirubinemia is when bilirubin builds up in the blood, tissues, and fluids. The bone marrow, liver, and spleen increase in size when immature red blood cells are produced. When the baby's organs cannot handle the anemia, they can go into heart failure and have fluid buildup in tissues/organs (Standord Medicine, 2021).

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HDFN occurs if the mother has antibodies against erythrocytes, if IgG binds to fetal erythrocytes and causes widespread anti-body mediated hemolysis or splenic removal, and if antibodies (usually IgG) crosses the placenta and enters fetal blood (McCance & Huether, 2019).

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Grace, Roxana, Julia, Chloe

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Hemolytic Disease of the Fetus and Newborn

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Hemolytic Disease of the Fetus and Newborn

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Hemolytic Disease of the Newborn, Animation